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Individual

SHINEQUA BRANDY WAITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
432 N 6TH ST, PHILADELPHIA, PA 19123-4004
(215) 627-8000
Mailing address
432 N 6TH ST, PHILADELPHIA, PA 19123-4004
(215) 627-8000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
658241
PA
163W00000X
Registered Nurse
685456
NY
363LW0102X
Women's Health Nurse Practitioner
421447
NY
363LW0102X
Women's Health Nurse Practitioner
Primary
SP022430
PA

Other

Enumeration date
01/03/2020
Last updated
04/08/2022
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