Individual
DEISHA FONTANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2970 CORPORATE CT, OREFIELD, PA 18069-3158
(610) 481-0444
Mailing address
3477 MAIN ST, SLATINGTON, PA 18080-1010
(484) 635-6250
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN310522
PA
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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