Individual
MICHELE R KINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7400 HAVERFORD AVE, E202, PHILADELPHIA, PA 19151-2938
(215) 921-9861
Mailing address
7400 HAVERFORD AVE, E202, PHILADELPHIA, PA 19151-2938
(610) 349-1143
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
275446
PA
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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