Provider Demographics
NPI:1073519187
Name:LAPA, KELLY ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:LAPA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 OLD YORK RD
Mailing Address - Street 2:STE 113
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3840
Mailing Address - Country:US
Mailing Address - Phone:215-517-1180
Mailing Address - Fax:
Practice Address - Street 1:1235 OLD YORK RD
Practice Address - Street 2:STE 113
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3840
Practice Address - Country:US
Practice Address - Phone:215-517-1180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008308363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA089060Medicare PIN