Individual
STACEY PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 316-5151
Mailing address
603 N AMERICAN ST APT 204, PHILADELPHIA, PA 19123-2961
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP021571
PA
Other
Enumeration date
08/23/2020
Last updated
08/23/2020
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