Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Oct 19, 2006
License(s)
RN1350942L (PA), UP005457-B (PA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 13579 | Reading, PA 19612-3579 | |
| LOCATION | 301 SOUTH SEVENTH AVE SUITE #340 | West Reading, PA 19611 | 610-988-4260 |
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