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Individual

JOHN J TAXIERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP

Contact information

Practice address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 349-8310
Mailing address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 349-8310

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L1-0043007
DE
363L00000X
Nurse Practitioner
LP-0000181
DE
363LA2200X
Adult Health Nurse Practitioner
Primary
SP017561
PA
363LC0200X
Critical Care Medicine Nurse Practitioner
LP-0000181
DE

Other

Enumeration date
09/07/2016
Last updated
07/21/2022
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