IDA ELISE BROADWATER

PHILADELPHIA, PA
NPI1598195307
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: PA  SP013545)
Enumeration Date2013-11-14
Last Update Date2013-12-20
Business Address
-- IDA ELISE BROADWATER CRNP
3400 SPRUCE STREET 6 SILVERSTEIN
PHILADELPHIA, PA 19104
Phone number: 215-615-4949
Mailing Address
-- IDA ELISE BROADWATER CRNP
3400 SPRUCE STREET 6 SILVERSTEIN
PHILADELPHIA, PA 19104
Phone number: 215-615-4949
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