Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | VP003198U | PA |
NPI | 1013281633 |
---|---|
Provider Name | Catherine Gill-Preston |
First Address | Philadelphia, PA 19107-5563 |
Second Address | Philadelphia, PA 19107-5563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2012 |
Last Update Date | 21/02/2014 |