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Individual

VIRGINIA FONASH SAMHOURI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
2137 WELSH RD, SUITE 1-C, PHILADELPHIA, PA 19115-4963
(215) 969-3944
(215) 969-3886
Mailing address
1394 TANGLEWOOD DR, NORTH WALES, PA 19454-3677
(215) 699-8199

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
UP006861H
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000910336
KHPE
PA
05
01021194286
PA
Enumeration date
07/07/2006
Last updated
07/08/2007
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