Individual
SUSANNA TILGHMAN RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3535 MARKET ST, SUITE 100, PHILADELPHIA, PA 19104-3309
(215) 746-3535
Mailing address
724 CORNELIA PL, PHILADELPHIA, PA 19118-4109
(215) 242-4693
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP-001001-C
PA
Other
Enumeration date
09/11/2007
Last updated
07/28/2009
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