Individual
MRS. AMANDA SUE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2130 S 21ST ST, PHILADELPHIA, PA 19145-3401
(215) 925-3566
Mailing address
16 SECRETARIAT CIR, MEDIA, PA 19063-5261
(616) 780-7354
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP018141
PA
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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