Individual
DR. BASHIRA CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, RN, CRNP
Contact information
Practice address
440 NORTH BROAD STREET, STUDENT HEALTH SERVICES, PHILADELPHIA, PA 10130-4015
(215) 400-5704
(215) 400-4173
Mailing address
738 LANDIS ST, PHILADELPHIA, PA 19124-3011
(215) 225-0325
(215) 400-4173
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP008021
PA
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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