Individual
LISA A COCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
211 S 9TH ST, V, PHILADELPHIA, PA 19107-6810
(215) 955-1925
Mailing address
211 S 9TH ST, SUITE 600, PHILADELPHIA, PA 19107-6810
(215) 955-1925
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NJ00004700
NJ
363L00000X
Nurse Practitioner
Primary
VP007017B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102881837
—
PA
Enumeration date
08/14/2006
Last updated
03/26/2014
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