Individual
MICHELLE J KUTALEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
219 N BROAD ST, 6TH FLOOR, PHILADELPHIA, PA 19107-1519
(215) 762-5080
(215) 561-8071
Mailing address
1601 CHERRY ST, SUITE 11511, PHILADELPHIA, PA 19102-1321
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
VP006157M
PA
Other
Enumeration date
06/26/2006
Last updated
08/31/2016
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