Provider Demographics
NPI:1770835936
Name:NORTHINGTON, KINA SHERRAN (BA)
Entity Type:Individual
Prefix:MS
First Name:KINA
Middle Name:SHERRAN
Last Name:NORTHINGTON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 LINDBERGH BLVD
Mailing Address - Street 2:PHILADELPHIA
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-5829
Mailing Address - Country:US
Mailing Address - Phone:267-777-0190
Mailing Address - Fax:
Practice Address - Street 1:5353 LINDBERGH BLVD
Practice Address - Street 2:PHILADELPHIA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-5829
Practice Address - Country:US
Practice Address - Phone:267-777-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator