Individual
JOELLE M MAFOUOTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
120 BURRUS BLVD STE 200, BRODHEADSVILLE, PA 18322-7812
(570) 420-6300
(570) 402-2920
Mailing address
2501 W LEHIGH AVE, PHILADELPHIA, PA 19132-3207
(215) 227-0300
(215) 227-0302
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
SP020022
PA
363LF0000X
Family Nurse Practitioner
Primary
SP020030
PA
Other
Enumeration date
02/27/2019
Last updated
04/01/2020
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