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Individual

THERESA M DUNFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
51 NORTH 39TH STREET, PHI-2C, PHILADELPHIA, PA 19104-2640
(215) 662-9010
Mailing address
51 N 39TH ST, 2 PHI, PHILADELPHIA, PA 19104-2640
(215) 662-9010

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NN04851900
NJ
363L00000X
Nurse Practitioner
Primary
SP006278P
PA

Other

Enumeration date
07/07/2006
Last updated
07/31/2013
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