Individual
DEHCONTEE GUAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
6212 WALNUT ST, PHILADELPHIA, PA 19139-3706
(215) 476-6264
(215) 689-0893
Mailing address
15 EAGLE WAY, AVONDALE, PA 19311-9723
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
LG0012151
DE
363LF0000X
Family Nurse Practitioner
Primary
SP019392
PA
Other
Enumeration date
10/11/2018
Last updated
02/13/2025
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