Individual provider · Type 1 NPI
Jacqueline Countess, CRNP
Gerontology Nurse Practitioner · Philadelphia, PA
NPI number
1700336930
Active
Practice location
3400 Spruce St, 4th Floor Silverstein- Surgery
Philadelphia, PA 19104-4238
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | SP016615 (PA) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1700336930
Jacqueline Countess, CRNP's National Provider Identifier is 1700336930, issued on Oct 12, 2016. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Philadelphia, PA. The record was last updated on Oct 13, 2016.