NPI 1063547966

Jivonne Nikell Prioleau-Green, HS

Practitioner Independent Duty Corpsman Philadelphia, PA

Practice location

Address: 1 Washington Ave, Philadelphia, PA 19147-4335
Phone: (215) 271-4816
Fax: (215) 271-4817
Mailing address: 7900a Stenton Ave APT 104, Philadelphia, PA 19118-3027

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1063547966
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Feb 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.