MEDICARE: MRS. KATELYN SULER CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	SP028574	PA

General Provider Information

NPI Number	:	1457127342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATELYN SULER CRNP

Provider Business Mailing Address
First Line	:	751 VANDENBURG RD APT 3127
Second Line	:
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-1676
Country	:	US
Telephone Number	:	215-589-3721
Fax Number	:

Provider Business Practice Location Address
First Line	:	817 E BALTIMORE PIKE STE A
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-1929
Country	:	US
Telephone Number	:	610-444-0113
Fax Number	:	610-444-0744

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2023
Last Update Date	:	11/30/2023

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