Individual
DIANE D GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
51 N 39TH ST, PHI , FLOOR 1, PHILADELPHIA, PA 19104-2640
(215) 662-8767
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-3958
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP010500
PA
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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