Individual
LISA ANN POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
134 EVERGREEN CT, MOUNT ROYAL, NJ 08061-1128
(856) 516-3844
Mailing address
134 EVERGREEN CT, MOUNT ROYAL, NJ 08061-1128
(856) 516-3844
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ01117300
NJ
Other
Enumeration date
03/17/2021
Last updated
03/17/2021
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