Individual
MS. KATHLEEN M NISHIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4510 FRANKFORD AVE, PHILADELPHIA, PA 19124-3602
(215) 744-1302
(215) 744-2544
Mailing address
1401 S 31ST ST, 2ND FLOOR, PHILADELPHIA, PA 19146-3506
(215) 925-2400
(215) 925-9162
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN355082L
PA
176B00000X
Midwife
Primary
MW008566L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001792598
—
PA
Enumeration date
09/20/2006
Last updated
04/06/2017
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