Individual
MRS. MARY GRACE REYTA ESTAMPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
925 CHESTNUT ST, PHILADELPHIA, PA 19107-4216
(215) 955-5050
Mailing address
925 CHESTNUT ST, PHILADELPHIA, PA 19107-4216
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR22203600
NJ
163W00000X
Registered Nurse
RN685502
PA
363LF0000X
Family Nurse Practitioner
Primary
SP027109
PA
Other
Enumeration date
03/20/2023
Last updated
04/01/2023
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