NPI 1760127773

Nafisa Sade Outlaw

Practitioner Military Health Care Provider Philadelphia, PA

Practice location

Address: 5804 N Marshall St, Philadelphia, PA 19120-1315
Phone: (268) 368-3955

Registered specialties

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X Licence 739258 (PA)

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Registry record

NPI: 1760127773
Entity type: Individual
Sex (as registered): Female
NPI issued: 3 May 2022
Record last updated: 3 May 2022

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.