Individual
JANUARY K FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 885-6927
Mailing address
316 FILLMORE ST, JENKINTOWN, PA 19046-4328
(215) 218-8700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
711628
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
SP035118
PA
Other
Enumeration date
06/25/2021
Last updated
04/30/2026
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