Individual
ANISA LYNN RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5045 WALNUT ST APT 3, PHILADELPHIA, PA 19139-3688
(336) 608-0303
Mailing address
5045 WALNUT ST APT 3, PHILADELPHIA, PA 19139-3688
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN719804
PA
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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