Individual
LISA JOAN DUFFY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
75 SOUTH WYOMING AVENUE SUITE 2, EDWARDSVILLE, PA 18704
(570) 824-2800
(570) 718-1476
Mailing address
75 SOUTH WYOMING AVENUE SUITE 2, EDWARDSVILLE, PA 18704
(570) 824-2800
(570) 718-1476
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP006462B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102377793
—
PA
Enumeration date
04/26/2007
Last updated
03/30/2012
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