Individual
KEREN MIODOVNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3500 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4395
(215) 590-1719
Mailing address
3500 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4395
(215) 590-1719
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP028080
PA
Other
Enumeration date
08/21/2023
Last updated
12/23/2024
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