Individual
LORISA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7203 SOMMERS RD, PHILADELPHIA, PA 19138-1307
(757) 839-7801
Mailing address
7203 SOMMERS RD, PHILADELPHIA, PA 19138-1307
(757) 839-7801
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN633735
PA
Other
Enumeration date
04/06/2018
Last updated
04/06/2018
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