Individual
CORINNE DERLETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(800) 879-2467
Mailing address
513 GREENWICH ST, PHILADELPHIA, PA 19147-6524
(860) 882-9408
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP029511
PA
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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