Individual
MS. JIVONNE NIKELL PRIOLEAU-GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HS
Contact information
Practice address
1 WASHINGTON AVE, PHILADELPHIA, PA 19147-4335
(215) 271-4816
(215) 271-4817
Mailing address
7900A STENTON AVE APT 104, PHILADELPHIA, PA 19118-3027
(215) 242-6187
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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