MEDICARE: KATHLEEN MCSORLEY 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	VP005058D	PA

General Provider Information

NPI Number	:	1851621023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN MCSORLEY CRNP

Provider Business Mailing Address
First Line	:	2035 COUNTRY CLUB DR
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-5922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	34TH STREET AND CIVIC CENTER BOULEVARD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4399
Country	:	US
Telephone Number	:	267-425-6446
Fax Number	:

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

Provider Enumeration Date	:	01/11/2010
Last Update Date	:	01/11/2010

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