Provider Demographics
NPI:1467696716
Name:NESTOR, KELLY ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANN
Last Name:NESTOR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:460 CREAMERY WAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2533
Mailing Address - Country:US
Mailing Address - Phone:610-280-7960
Mailing Address - Fax:
Practice Address - Street 1:150 E PENNSYLVANIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2602
Practice Address - Country:US
Practice Address - Phone:610-280-7960
Practice Address - Fax:610-280-7962
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010294363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health