Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP022787 | PA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP022787 | PA |
N | 363LG0600X | Nurse Practitioner - Gerontology | SP022787 | PA |
NPI | 1497356190 |
---|---|
Provider Name | Nadria Yasmeen Kasumu |
First Address | Elkins Park, PA 19027-3022 |
Second Address | Elkins Park, PA 19027-3022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2020 |
Last Update Date | 08/11/2020 |