Individual
JENNIFER ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 TABOR AVE, PHILADELPHIA, PA 19120-2124
(215) 388-1806
Mailing address
142 LEAGUE ST, PHILADELPHIA, PA 19147-4225
(215) 207-5266
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN532587
PA
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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