Individual
KEESHA YVONNE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6623 N LAWRENCE ST, PHILADELPHIA, PA 19126-3133
(215) 307-0616
Mailing address
960A HARVEST DR # 100, BLUE BELL, PA 19422-1991
(610) 825-9360
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN308177
PA
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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