Individual
VENESSA LYNN MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 CIVIC CENTER BLVD, 2 EAST PAVILION, PHILADELPHIA, PA 19104-5127
(215) 615-4949
Mailing address
3400 CIVIC CENTER BLVD, 2 EAST PAVILION, PHILADELPHIA, PA 19104-5127
(215) 615-4949
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SP018287
PA
Other
Enumeration date
01/29/2018
Last updated
01/30/2018
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