Healthcare Provider Details

I. General information

NPI: 1528309648
Provider Name (Legal Business Name): LORI ANN ALBRIGHT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 MONUMENT RD
PHILADELPHIA PA
19131-1625
US

IV. Provider business mailing address

5501 OLD YORK RD
PHILADELPHIA PA
19141-3018
US

V. Phone/Fax

Practice location:
  • Phone: 215-877-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP012803
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: