Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP023081 | PA |
NPI | 1033781463 |
---|---|
Provider Name | Joanna Sutor |
First Address | Philadelphia, PA 19106-4525 |
Second Address | Philadelphia, PA 19107-5001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2021 |
Last Update Date | 14/07/2021 |