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1831497601

NPI Code Detail

MEDICARE: AISHA AYANNA ADDISON

MEDICARE: AISHA AYANNA ADDISON

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	363LF0000X	Family Nurse Practitioner	26NJ008494	NJ
2	363LF0000X	Family Nurse Practitioner	SP011279	PA
3	363LF0000X	Family Nurse Practitioner	LG0001115	DE
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	SP026645	PA
5	363LX0106X	Occupational Health Nurse Practitioner	LG0001115	DE
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ008494	NJ

General Provider Information

NPI Number	:	1831497601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AISHA AYANNA ADDISON

Provider Business Mailing Address
First Line	:	525 ROUTE 73 N STE 117
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-3422
Country	:	US
Telephone Number	:	302-273-3926
Fax Number	:	609-604-1325

Provider Business Practice Location Address
First Line	:	2418 E YORK ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19125-3006
Country	:	US
Telephone Number	:	302-273-3926
Fax Number	:	609-604-1325

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

Provider Enumeration Date	:	03/03/2011
Last Update Date	:	07/31/2025

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Directions to “ AISHA AYANNA ADDISON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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