Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP018341 | PA |
NPI | 1023514981 |
---|---|
Provider Name | Victoria Kim Leri |
First Address | Wynnewood, PA 19096-3518 |
Second Address | Philadelphia, PA 19107-5002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2018 |
Last Update Date | 04/04/2018 |