Individual
MS. ELENA KONAKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10101 ACADEMY RD, SUITE 104, PHILADELPHIA, PA 19114-1177
(215) 710-3783
Mailing address
857 THOREAU CT, WARMINSTER, PA 18974-2057
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
SP012935
PA
363LF0000X
Family Nurse Practitioner
Primary
SP017116
PA
Other
Enumeration date
01/05/2014
Last updated
03/03/2017
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