Organization · NPI-2

A Fulfilling Life

Registered Nurse, General Practice · Philadelphia, PA

NPI number1396693909
StatusActive
Last updated in NPPESMar 19, 2026

Details

NPI
1396693909
Entity type
Organization (NPI-2)
Legal business name
A Fulfilling Life
Organization subpart
No
Enumeration date
Mar 19, 2026
Certification date
Mar 19, 2026
Last updated
Mar 19, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice––Yes
164W00000X Licensed Practical Nurse––

Practice location

3000 W Master St Apt 408
Philadelphia, PA 19121-4416

Phone 215-416-8664

Mailing address

3000 W Master St Apt 408
Philadelphia, PA 19121-4416

Phone 215-416-8664

Authorized official

Kenya Kenyatta Reed
Ceo
2154168664

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