Individual
KENYA GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
6514 HARLAN ST, PHILADELPHIA, PA 19151-3709
(484) 614-8838
Mailing address
6514 HARLAN ST, PHILADELPHIA, PA 19151-3709
(484) 614-8838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP011360
PA
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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