Individual
LATESHA L COLBERT-MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 SPRUCE ST, 4 SILVERSTEIN BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-2050
Mailing address
3400 SPRUCE ST, 4 SILVERSTEIN BUILDING, PHILADELPHIA, PA 19104-4206
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP008354
PA
Other
Enumeration date
11/06/2006
Last updated
04/11/2025
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