| NPI | 1639954076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER R NELSON Admin 215-768-5885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health |
| 207QA0401X Family Medicine Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2023-08-25 |