Individual
MRS. LISA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
729 GROVE AVE, SOUTHAMPTON, PA 18966-6008
(215) 322-0800
(215) 322-2073
Mailing address
729 GROVE AVE, SOUTHAMPTON, PA 18966-6008
(215) 322-0800
(215) 322-2073
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP011196
PA
363LP0200X
Pediatric Nurse Practitioner
SP011196
PA
Other
Enumeration date
02/04/2015
Last updated
05/29/2024
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