Individual
MRS. KADIAN SASHA-GAY ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1401 S 31ST ST, PHILADELPHIA, PA 19146-3506
(215) 925-2400
(215) 925-9162
Mailing address
1401 S 31ST ST FL 2, PHILADELPHIA, PA 19146-3506
(215) 925-9162
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP021495
PA
Other
Enumeration date
02/21/2011
Last updated
03/09/2020
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