Individual
JUSTINE KOHLEPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2100 N FRONT ST, PHILADELPHIA, PA 19122-1705
(215) 425-8100
(267) 861-6410
Mailing address
136 DIAMOND ST, PHILADELPHIA, PA 19122-1797
(215) 426-8100
(267) 861-6410
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN295851
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30-037-307
DRIVER'S LICENSE
PA
Enumeration date
02/24/2023
Last updated
02/24/2023
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