Individual
THERESA C MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 590-1527
Mailing address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-5127
(215) 590-1527
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NJ00019600
NJ
363L00000X
Nurse Practitioner
Primary
VP003683B
PA
Other
Enumeration date
07/13/2006
Last updated
12/17/2014
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