Individual
LORI PELLEGRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1100 WALNUT ST, SUITE 500, PHILADELPHIA, PA 19107-5563
(215) 955-6750
Mailing address
1100 WALNUT ST, SUITE 500, PHILADELPHIA, PA 19107-5563
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP012475
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102866661
—
PA
Enumeration date
11/30/2012
Last updated
01/28/2014
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