Provider Demographics
NPI:1114061306
Name:LEFEVRE, MAUREEN KELLY (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:KELLY
Last Name:LEFEVRE
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 1:196 W. SPROUL RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064
Mailing Address - Country:US
Mailing Address - Phone:610-604-0888
Mailing Address - Fax:610-604-0880
Practice Address - Street 1:602 S BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5800
Practice Address - Country:US
Practice Address - Phone:215-643-7771
Practice Address - Fax:215-643-9463
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP000490D363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner