Individual
MISS KORI ELIZABETH MANFREDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP, FNP-BC
Contact information
Practice address
1626 LOCUST ST, PHILADELPHIA, PA 19103
(470) 410-4080
Mailing address
3504 IVY DR, MURRYSVILLE, PA 15668-1607
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP017974
PA
Other
Enumeration date
10/16/2017
Last updated
05/12/2025
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