Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | RN219155L | PA |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | UP001577G | PA |
NPI | 1053481085 |
---|---|
Provider Name | Patricia Callahan |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104-4206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 19/10/2012 |