Individual
TIANA BODISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 316-5151
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
SP026858
PA
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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