Individual
NICOLE JADAWN PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6765 GERMANTOWN AVENUE, PHILADELPHIA, PA 19119
(267) 986-1728
Mailing address
6765 GERMANTOWN AVENUE, PHILADELPHIA, PA 19119
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN322436
PA
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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