Organization
MEMORIAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA ANN HASLETT MSN, CRNP (NURSE PRACTITIONER)
(814) 534-9503
Entity
Organization
Contact information
Practice address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 534-9503
Mailing address
434 BLUE RIDGE DR, MOON TWP, PA 15108-5500
(724) 457-1511
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
VP001816J
PA
Other
Enumeration date
06/13/2007
Last updated
03/19/2012
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