Individual
MS. NELLIE RIENDEAU LAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3535 MARKET ST. STE. 1371, CHOP ADOLESCENT INITIATIVE, PHILADELPHIA, PA 19104-5021
(215) 590-3626
(215) 590-0426
Mailing address
3535 MARKET ST. STE. 1371, CHOP ADOLESCENT INITIATIVE, PHILADELPHIA, PA 19104-5021
(215) 590-3626
(215) 590-0426
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
SP008400
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024965980001
—
PA
01
—
1891778239
NPI
—
Enumeration date
11/21/2005
Last updated
12/17/2014
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