Venessa Lynn Medina
Nurse Practitioner - Gerontology
3400 Civic Center Blvd 2 East Pavilion
Philadelphia
, Pennsylvania 19104-5127
Venessa Lynn Medina
Nurse Practitioner - Gerontology
3400 Civic Center Blvd 2 East Pavilion
Philadelphia
, Pennsylvania 19104-5127
(215) 615-4949
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Venessa Lynn Medina
- 3400 Civic Center Blvd 2 East Pavilion
- Philadelphia, PA
- Zip : 19104-5127
- Phone : (215) 615-4949
Second Address
- Venessa Lynn Medina
- 3400 Civic Center Blvd 2 East Pavilion
- Philadelphia, PA
- Zip : 19104-5127
- Phone : (215) 615-4949
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | SP018287 | PA |
National Provider Identifier
| NPI | 1063910651 |
|---|---|
| Provider Name | Venessa Lynn Medina |
| First Address | Philadelphia, PA 19104-5127 |
| Second Address | Philadelphia, PA 19104-5127 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/01/2018 |
| Last Update Date | 30/01/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.