Individual
NEIDA JALISSE QUINONES STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 829-6821
Mailing address
38 JUDYS CT, HAMMONTON, NJ 08037-2118
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP029560
PA
Other
Enumeration date
10/04/2024
Last updated
10/09/2024
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