Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP006067B | PA |
NPI | 1295808772 |
---|---|
Provider Name | Jannette Delcampo |
First Address | Philadelphia, PA 19143-1524 |
Second Address | Philadelphia, PA 19143-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 14/03/2016 |