Organization
BEPPU
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANINE DUNMORE CRNP (DIRECTOR)
(215) 341-1327
Entity
Organization
Contact information
Practice address
6378 WOODBINE AVE, PHILADELPHIA, PA 19151-2526
(215) 341-1327
Mailing address
6378 WOODBINE AVE, PHILADELPHIA, PA 19151-2526
(215) 341-1327
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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