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1598195307
IDA ELISE BROADWATER
PHILADELPHIA, PA
NPI
1598195307
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: PA SP013545)
Enumeration Date
2013-11-14
Last Update Date
2013-12-20
Business Address
-- IDA ELISE BROADWATER CRNP
3400 SPRUCE STREET 6 SILVERSTEIN
PHILADELPHIA, PA 19104
Phone number: 215-615-4949
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Mailing Address
-- IDA ELISE BROADWATER CRNP
3400 SPRUCE STREET 6 SILVERSTEIN
PHILADELPHIA, PA 19104
Phone number: 215-615-4949
Copy
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