Provider Demographics
NPI:1881746774
Name:CHIRICO, KELLY (APNC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:CHIRICO
Suffix:
Gender:F
Credentials:APNC
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Mailing Address - Street 1:500 GROVE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-796-9200
Mailing Address - Fax:856-796-9397
Practice Address - Street 1:63 KRESSON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3200
Practice Address - Country:US
Practice Address - Phone:856-751-7420
Practice Address - Fax:856-424-3113
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2014-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NN10007600363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner