Individual provider · Type 1 NPI
Venessa Lynn Medina
Gerontology Nurse Practitioner · Philadelphia, PA
NPI number
1063910651
Active
Practice location
3400 Civic Center Blvd, 2 East Pavilion
Philadelphia, PA 19104-5127
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | SP018287 (PA) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1063910651
Venessa Lynn Medina's National Provider Identifier is 1063910651, issued on Jan 29, 2018. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Philadelphia, PA. The record was last updated on Jan 30, 2018.