Individual
LISA MARIE MANGINO-BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-9595
Mailing address
51 N 39TH ST, PHILADELPHIA, PA 19104-2640
(215) 662-9595
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP007067
PA
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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