Individual
MRS. CHENIECE DE ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
6212 WALNUT ST, PHILADELPHIA, PA 19139-3706
(215) 476-6264
Mailing address
6212 WALNUT ST, PHILADELPHIA, PA 19139-3706
(610) 835-2471
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP030221
PA
Other
Enumeration date
08/05/2024
Last updated
08/26/2024
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