Provider Demographics
NPI:1275782906
Name:JERLA, KATHLEEN DALIN (CRNP)
Entity Type:Individual
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First Name:KATHLEEN
Middle Name:DALIN
Last Name:JERLA
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:34 TH ST AND CIVIC CENTER BLVD
Mailing Address - Street 2:ANESTHESIA RESOURCE CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4399
Mailing Address - Country:US
Mailing Address - Phone:267-425-4650
Mailing Address - Fax:267-425-4469
Practice Address - Street 1:34 TH ST AND CIVIC CENTER BLVD
Practice Address - Street 2:ANESTHESIA RESOURCE CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4399
Practice Address - Country:US
Practice Address - Phone:267-425-4650
Practice Address - Fax:267-425-4469
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-11-04
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Provider Licenses
StateLicense IDTaxonomies
PAVP006581D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics