Individual
LIZA COLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
9501 ROOSEVELT BLVD, PHILADELPHIA, PA 19114-1025
(215) 969-4917
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-1324
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP026042
PA
Other
Enumeration date
06/23/2022
Last updated
03/21/2023
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