Individual
LORRIE CHISLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1919 COTTMAN AVE, PHILADELPHIA, PA 19111-3816
(215) 728-4639
(215) 745-6511
Mailing address
1919 COTTMAN AVE, PHILADELPHIA, PA 19111-3816
(215) 728-4639
(215) 745-6511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN744947
PA
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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