Individual
LANAE ALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5000 PARKSIDE AVE, PHILADELPHIA, PA 19131-4714
(215) 879-6116
Mailing address
637 N FRAZIER ST, PHILADELPHIA, PA 19131-4810
(267) 325-2083
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN297054
PA
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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