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Organization

KINGSTREE GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATRICIA C MARRA RN,BSN (NURSE CASE COORDINATOR)
(888) 853-6412
Entity
Organization

Contact information

Practice address
900 W VALLEY RD STE 300, WAYNE, PA 19087-1852
(888) 853-6412
(888) 898-3857
Mailing address
405 HOLSTEIN CT, MIDDLETOWN, DE 19709-6811
(888) 898-3857
(888) 898-3857

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
L10030304
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L10030304
DELAWARE NURSING LICENSE
DE
Enumeration date
01/26/2013
Last updated
01/26/2013
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