Individual
TESSA AGBONIFIOROR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
7901 STATE RD, PHILADELPHIA, PA 19136-3407
(215) 685-7843
Mailing address
7901 STATE RD, PHILADELPHIA, PA 19136-3407
(717) 495-5049
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP014772
PA
Other
Enumeration date
05/28/2015
Last updated
05/02/2024
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