Individual
AGNES ITUNGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
920 CENTURY DR, MECHANICSBURG, PA 17055-8417
(717) 766-6974
(717) 766-6975
Mailing address
4218 NANTUCKET DR, MECHANICSBURG, PA 17050-9105
(717) 425-4078
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN304876
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000642725
ID
PA
Enumeration date
04/13/2022
Last updated
04/13/2022
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