Individual
MRS. LAUREN POTTER ELICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1000
Mailing address
748 SOUTH FRONT STREET, 1F, PHILADELPHIA, PA 19147
(856) 981-3711
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP018252
PA
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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