Individual
LISA COSSABOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
372 EGG HARBOR RD STE 4A, SEWELL, NJ 08080-1988
(856) 218-5900
(856) 497-5207
Mailing address
134 BRIDGETON PIKE STE C, MULLICA HILL, NJ 08062-2616
(856) 507-2783
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ01294300
NJ
Other
Enumeration date
04/13/2022
Last updated
07/14/2025
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