Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP011258 | PA |
NPI | 1033416052 |
---|---|
Provider Name | Mrs. Lauren N. Lyszkowski |
First Address | Malvern, PA 19355 |
Second Address | Malvern, PA 19355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2011 |
Last Update Date | 29/12/2016 |