Individual
JUNE SUPEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
15 PUBLIC SQ, SUITE312, WILKES BARRE, PA 18701-1702
(570) 826-1777
(570) 823-3040
Mailing address
15 PUBLIC SQ, SUITE 600, WILKES BARRE, PA 18701-1702
(570) 826-1777
(570) 823-3040
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN137197L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007678420038
GROUP NUMBER
PA
05
—
1015827080003
—
PA
Enumeration date
04/16/2007
Last updated
06/20/2011
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