Provider Demographics
NPI:1346217940
Name:TRYNOSKY, KELLY J (CRNP)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:J
Last Name:TRYNOSKY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-721-5868
Mailing Address - Fax:717-721-5881
Practice Address - Street 1:446 N READING RD STE 302
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9802
Practice Address - Country:US
Practice Address - Phone:717-721-5868
Practice Address - Fax:717-721-5881
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008772363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA098212Medicare ID - Type Unspecified
PAQ63184Medicare UPIN