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Organization
NURSING MOTHERS
Active
Organization
NURSING MOTHERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENEVERE JENRETTE (DIRECTOR)
(610) 745-2431
Entity
Organization
Contact information
Practice address
321 E 9TH ST, CHESTER, PA 19013-6020
(610) 745-2431
Mailing address
321 E 9TH ST, CHESTER, PA 19013-6020
(610) 745-2431
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN094573L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932647633
—
PA
Enumeration date
05/04/2017
Last updated
05/04/2017
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