Individual
IYATUNDE GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7615 DICKENS AVE, PHILADELPHIA, PA 19153-1310
(215) 617-8631
Mailing address
7615 DICKENS AVE, PHILADELPHIA, PA 19153-1310
(215) 617-8631
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN561739
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210585439
HOME HEALTH AGENCY
PA
05
—
210585439
—
PA
Enumeration date
08/10/2020
Last updated
11/27/2023
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