Individual
ANNA WAKEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4118 GREEBY ST, PHILA, PA 19135-2517
(267) 949-7698
Mailing address
4118 GREEDY STREET, PHILA, PA 19135
(267) 949-7698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP006144B
PA
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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