MEDICARE: MS. MAUREEN KELLY LEFEVRE 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	363L00000X	Nurse Practitioner	VP000490D	PA

General Provider Information

NPI Number	:	1114061306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAUREEN KELLY LEFEVRE CRNP

Provider Business Mailing Address
First Line	:	196 W. SPROUL RD
Second Line	:	SUITE 205
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064
Country	:	US
Telephone Number	:	610-604-0888
Fax Number	:	610-604-0880

Provider Business Practice Location Address
First Line	:	602 S BETHLEHEM PIKE
Second Line	:
City	:	AMBLER
State	:	PA
Zip	:	19002-5800
Country	:	US
Telephone Number	:	215-643-7771
Fax Number	:	215-643-9463

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	01/07/2015

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