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Individual

CHERYL STOUDT LICHNER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
6900 HAMILTON BOULEVARD, TREXLERTOWN, PA 18087
(610) 402-0170
Mailing address
1650 VALLEY CENTER PKWY, SUITE 100, BETHLEHEM, PA 18017-2344
(484) 884-4436
(484) 884-4444

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP000994
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
197466
HIGHMARK BLUE SHIELD
PA
01
50029571
CAPITAL
PA
Enumeration date
05/26/2006
Last updated
07/08/2007
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