Individual
WINNIE SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5864
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5864
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP026708
PA
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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