IndividualActive
Jivonne Prioleau-Green, HS
NPI 1063547966 · Independent Duty Corpsman · Philadelphia, PA
Provider details
- NPI number
- 1063547966
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- HS
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
1 Washington Ave
Philadelphia, PA 19147-4335
Phone: (215) 271-4816
Fax: (215) 271-4817
Approximate (ZIP-level) locationGet directions
Mailing address
7900a Stenton Ave Apt 104
Philadelphia, PA 19118-3027
Registry dates
- Enumerated
- 2007-02-22
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.