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General NPI Number Information
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NPI Number | 1396693909
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Entity Type | Organization
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Legal Business Name | A FULFILLING LIFE
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 3000 W MASTER ST APT 408
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City | PHILADELPHIA
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State | PA
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Zip | 19121-4416
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Country | US
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Telephone | 215-416-8664
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 W MASTER ST APT 408
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City | PHILADELPHIA
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State | PA
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Zip | 19121-4416
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Country | US
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Telephone | 215-416-8664
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KENYA KENYATTA REED
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Credential | MS
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Telephone | 215-416-8664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number |
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License Number State |
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