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General NPI Number Information
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NPI Number | 1982495057
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Entity Type | Individual
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Provider Name | LISA CHEA
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Gender | Female
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 70 E SWEDESFORD RD STE 130
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City | MALVERN
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State | PA
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Zip | 19355-1482
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Country | US
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Telephone | 484-318-2268
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Fax |
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Provider Business Mailing Address
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Address Line | 250 ROBERTS DR
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-1735
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Country | US
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Telephone | 215-380-6042
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP030528
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License Number State | PA
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