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General NPI Number Information
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NPI Number | 1124494869
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Entity Type | Individual
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Provider Name | KIMNGAN THI VELOTT CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 2401 PARK DR STE 101
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City | HARRISBURG
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State | PA
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Zip | 17110-9303
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Country | US
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Telephone | 717-686-9842
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Fax |
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Provider Business Mailing Address
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Address Line | 409 S 2ND ST SUITE 2F
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City | HARRISBURG
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State | PA
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Zip | 17104-1612
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Country | US
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Telephone | 717-724-6500
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Fax | 717-721-6510
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP015392
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License Number State | PA
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