MEDICARE: MRS. PATRICIA LIPPERT DIEHL CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	VP003311-D	PA

General Provider Information

NPI Number	:	1346342094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA LIPPERT DIEHL CRNP

Provider Business Mailing Address
First Line	:	110 SUNNYBROOK RD
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-3813
Country	:	US
Telephone Number	:	856-795-0119
Fax Number	:

Provider Business Practice Location Address
First Line	:	2546 KNIGHTS RD
Second Line	:
City	:	BENSALEM
State	:	PA
Zip	:	19020-3400
Country	:	US
Telephone Number	:	215-245-8873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	07/08/2007

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