Individual
MS. MILDRED D. BOETTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
34TH AND CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-3630
(215) 590-3606
Mailing address
34TH AND CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-3630
(215) 590-3606
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
TP004267N
PA
363LP0200X
Pediatric Nurse Practitioner
TP004267N
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8668809
—
NJ
Enumeration date
09/28/2006
Last updated
08/07/2008
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