Individual
NICOLE LYNN LYDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 316-5151
Mailing address
51 N 39TH ST FL 3, PHILADELPHIA, PA 19104-2640
(215) 494-6927
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN685393
PA
363L00000X
Nurse Practitioner
Primary
SP025107
PA
Other
Enumeration date
10/20/2021
Last updated
06/03/2025
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