Individual
SHONDA R GASKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1745 N 4TH ST, PHILADELPHIA, PA 19122-3008
(215) 236-1000
Mailing address
835 S ALDEN ST, PHILADELPHIA, PA 19143-2713
(267) 303-3568
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN308583
PA
Other
Enumeration date
08/11/2023
Last updated
08/11/2023
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