Kenneth Charles Agnew Jr., CRNP
Nurse Practitioner, Primary Care in Erie, PA. Individual provider (NPI-1).
NPI number1013657295
StatusActive
Last updated in NPPESMar 29, 2022
Details
- NPI
- 1013657295
- Entity type
- Individual (NPI-1)
- Name
- Mr. Kenneth Charles Agnew Jr.
- Credential
- CRNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 29, 2022
- Certification date
- Mar 29, 2022
- Last updated
- Mar 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | SP025288 | PA | Yes |
Practice location
5037 Crystal DrErie, PA 16505-2913
Phone 814-218-1850
Mailing address
5037 Crystal DrErie, PA 16505-2913
Phone 814-218-1850
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