Individual
TINA M O'MARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-4300
Mailing address
9461 LANSFORD ST, PHILADELPHIA, PA 19114-2625
(215) 380-9237
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP025465
PA
Other
Enumeration date
05/03/2022
Last updated
09/21/2022
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