Individual
MRS. CHRISTINE NIERODA CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
211 S. 9TH STREET, SUITE 600, PHILADELPHIA, PA 19107
(215) 955-1925
(215) 928-3160
Mailing address
211 S. 9TH STREET, SUITE 600, PHILADELPHIA, PA 19107-6810
(215) 955-1925
(215) 928-3160
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
VP004645C
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
VP004645C
PA
363LP2300X
Primary Care Nurse Practitioner
VP004645C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103075213
—
PA
Enumeration date
07/25/2006
Last updated
10/25/2018
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