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General NPI Number Information
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NPI Number | 1811570112
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Entity Type | Organization
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Legal Business Name | NURSES UNITED AGAINST COVID19
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 02/07/2022
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Provider Practice Location Address
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Address Line | 3939 WARREN STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 267-254-9771
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Fax | 215-382-5803
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Provider Business Mailing Address
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Address Line | 5751 PINE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1215
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Country | US
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Telephone | 267-254-9771
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Fax | 215-382-5803
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | MRS. DAVEDA JUNE GRAHAM
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Credential | CRNP
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Telephone | 267-588-2328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number |
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License Number State |
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