Individual provider · Type 1 NPI
Othello Saye Kwaidah, CRNP
Family Nurse Practitioner · Philadelphia, PA
NPI number
1477051514
Active
Practice location
3401 N Broad St
Philadelphia, PA 19140
Fax (215) 707-9697
Mailing address
2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | SP018472 (PA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1477051514
Othello Saye Kwaidah, CRNP's National Provider Identifier is 1477051514, issued on Jan 23, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Philadelphia, PA. The record was last updated on Jun 22, 2018.