Individual provider · NPI-1

Lisa Abdul-Haqq, CRNP

Nurse Practitioner, Primary Care · Philadelphia, PA

NPI number1982369708
StatusActive
Last updated in NPPESMay 26, 2022

Details

NPI
1982369708
Entity type
Individual (NPI-1)
Name
Lisa Abdul-Haqq
Credential
CRNP
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 5, 2021
Certification date
May 26, 2022
Last updated
May 26, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP2300X Nurse Practitioner, Primary CareSP024729PAYes

Practice location

6431 Sackett St
Philadelphia, PA 19149

Phone 267-448-4908 · Fax 267-297-3950

Mailing address

6431 Sackett St
Philadelphia, PA 19149

Phone 267-448-4908 · Fax 267-297-3950

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