Provider Demographics
NPI:1952071524
Name:CHILA, CAROLYN MARIE DUCA (RN)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARIE DUCA
Last Name:CHILA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 LANVALE PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-5450
Mailing Address - Country:US
Mailing Address - Phone:267-738-4064
Mailing Address - Fax:
Practice Address - Street 1:3120 LANVALE PL
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-5450
Practice Address - Country:US
Practice Address - Phone:267-738-4064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN668378163WN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0300XNursing Service ProvidersRegistered NurseNephrology