Individual
NICOLE BRAVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2970 CORPORATE CT STE 1, OREFIELD, PA 18069-3158
(610) 481-9075
Mailing address
5635 WEDGE LN, ALLENTOWN, PA 18106-9664
(484) 569-0422
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN289575
PA
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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