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Individual

MRS. KATHRYN L CHICANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104
(215) 823-4459
Mailing address
814 CALEDONIA ST, PHILADELPHIA, PA 19128-1103
(215) 823-4459

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP004328C
PA
363LA2200X
Adult Health Nurse Practitioner
Primary
SP004328C
PA
363LP2300X
Primary Care Nurse Practitioner
SP004328C
PA

Other

Enumeration date
08/03/2006
Last updated
05/21/2018
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