Individual
SHEEBA LEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4488
Mailing address
7515 STENTON AVE, PHILADELPHIA, PA 19150-3710
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP018952
PA
Other
Enumeration date
07/02/2018
Last updated
12/18/2018
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