Chalise L Lark CRNA

NPI 1598096463 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1598096463
Gender Female
Enumeration Date 01/16/2010
Last Updated 07/18/2012
Entity Type Individual
Active Over 6 years ago
Practice Location
5501 OLD YORK RD
TOWER 3
PHILADELPHIA PA, 19141-3018, US
Phone (215) 456-6850
Fax (215) 456-8539
Business Location
PO BOX 8500-8735
PHILADELPHIA PA, 19178-0001, US
Phone (215) 456-7000
Fax (215) 254-2599
Toxanomy
Taxonomy Code 367500000X
License State Pennsylvania
License Number RN539928
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According to our database, Chalise L Lark CRNA NPI is 1598096463, taxonomy code is 367500000X and license number is RN539928, license state is located at Pennsylvania. Chalise L Lark CRNA physically located at 5501 Old York Rd, Philadelphia PA, 19141-3018. NPI Number Chalise L Lark CRNA has the Individual type.

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1598096463 NPI number is provided on an as is basis without warranty of any kind. 1598096463 is maintained by the National Plan & Provider Enumeration System. The contents of Chalise L Lark CRNA are for informational purposes only.