Healthcare Provider Details

I. General information

NPI: 1861225906
Provider Name (Legal Business Name): KHRYSTYNA KOBYLYNETS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 WESTLAKES DR STE 3152
BERWYN PA
19312-2410
US

IV. Provider business mailing address

1541 TARLETON PL
WARMINSTER PA
18974-3811
US

V. Phone/Fax

Practice location:
  • Phone: 215-346-6050
  • Fax: 215-220-3562
Mailing address:
  • Phone: 267-902-0272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP029641
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: