OrganizationActive
A Fulfilling Life
NPI 1396693909 · General Practice Registered Nurse · Philadelphia, PA
Provider details
- NPI number
- 1396693909
- Entity type
- Organization
- Primary specialty
- General Practice Registered NurseNursing Service Providers
- Organization subpart
- No
- Authorized official
- Kenya Reed, Ceo(215) 416-8664
Specialties & taxonomies
Nursing Service Providers
- Licensed Practical Nurse164W00000X
Nursing Service Providers
Practice location
3000 W Master St Apt 408
Philadelphia, PA 19121-4416
Phone: (215) 416-8664
Approximate (ZIP-level) locationGet directions
Mailing address
3000 W Master St Apt 408
Philadelphia, PA 19121-4416
Registry dates
- Enumerated
- 2026-03-19
- Last updated
- 2026-03-19
- Certified
- 2026-03-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.