NPI 1528817004

Coretha Smith-Johnson, MASTERPUBLICHEALTH

Practitioner Nursing Home Administrator Philadelphia, PA

Practice location

Address: 6603 Souder St, Philadelphia, PA 19149-2207
Phone: (215) 280-0867
Mailing address: 6416 Lawnton Ave, Philadelphia, PA 19126-3742

Registered specialties

Nursing Home Administrator Primary

Nursing Service Related Providers Taxonomy 376G00000X

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Registry record

NPI: 1528817004
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 May 2024
Record last updated: 16 May 2024

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.