MEDICARE: MRS. LISA KLINGER ARNP

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	363LA2200X	Adult Health Nurse Practitioner	TP001014C	PA

General Provider Information

NPI Number	:	1740402197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA KLINGER ARNP

Provider Business Mailing Address
First Line	:	281 IVY LN
Second Line	:
City	:	GLEN MILLS
State	:	PA
Zip	:	19342-1327
Country	:	US
Telephone Number	:	610-209-5257
Fax Number	:	610-499-1181

Provider Business Practice Location Address
First Line	:	1 UNIVERSITY PL
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-5700
Country	:	US
Telephone Number	:	610-499-1184
Fax Number	:	610-499-1181

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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