Individual
SIERRA ALEXIS GADSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2151 KNORR ST, PHILADELPHIA, PA 19149-2307
(267) 456-9935
Mailing address
2151 KNORR ST, PHILADELPHIA, PA 19149-2307
(267) 456-9935
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN312769
PA
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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