Individual
MS. ELEANOR LYNN VANDERKLOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
925 CHESTNUT ST, SUITE 320A, PHILADELPHIA, PA 19107-4216
(215) 955-8874
Mailing address
925 CHESTNUT ST, SUITE 320A, PHILADELPHIA, PA 19107-4216
(215) 955-8874
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP010656
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102894693
—
PA
Enumeration date
08/10/2010
Last updated
02/18/2015
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