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General NPI Number Information
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NPI Number | 1972579225
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Entity Type | Individual
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Provider Name | KELLY MORGANTINI-PEPE NP
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Gender | Female
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 575 N RIVER ST
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City | WILKES BARRE
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State | PA
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Zip | 18764-0999
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Country | US
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Telephone | 570-270-9192
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Fax |
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Provider Business Mailing Address
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Address Line | 198 ERIE AVE
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City | WEST PITTSTON
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State | PA
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Zip | 18643-2656
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Country | US
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Telephone | 570-472-1896
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP007035B
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License Number State | PA
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