Individual
KRISTA GRACE RAKICKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 275-0527
Mailing address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
SP016938
PA
Other
Enumeration date
07/31/2017
Last updated
07/31/2017
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