Individual
MRS. LISA JO MATHERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2050 OLD WEST CHESTER PIKE, HAVERTOWN, PA 19083-2712
(610) 449-8600
(610) 449-1302
Mailing address
271 GREEN HOLLOW RD, GLENMOORE, PA 19343-1509
(610) 913-8008
(610) 913-8007
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SPOO3533H
PA
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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