Individual
KATHERINE DISSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
5003 UMBRIA ST, PHILADELPHIA, PA 19128-4369
(215) 483-3444
Mailing address
4626 SPRUCE ST APT 4, PHILADELPHIA, PA 19139-4582
(203) 434-0559
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP028706
PA
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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