LISA MARIE LYCKSELL

Address: 3400 Spruce St, 3 Silverstein Building, Philadelphia, PA 19104-4206
Phone: 2156623487

LISA MARIE LYCKSELL (NPI# 1578848305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1578848305
Entity Type 1 - Individual
Full Name LISA MARIE LYCKSELL
Credential CRNP
Practice Address 3400 Spruce St
3 Silverstein Building
Philadelphia
PA 19104-4206
Practice Telephone 2156623487
Enumeration Date 10/12/2011
Last Update Date 08/07/2012
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
RN592334 PA Physician Assistants & Advanced Practice Nursing Providers
N 363LF0000X Nurse Practitioner
Specialization: Family
SP011492 PA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 3400 SPRUCE ST
3 SILVERSTEIN BUILDING
City PHILADELPHIA
State PA
Zip Code 19104-4206

Providers with the same location

NPI Name Address
1063415966 SAMUEL ISAIAH PARRY 3400 Spruce St, 2000 Courtyard, Philadelphia, PA 19104-4206
1447254362 AMY CAMPBELL LORENZO 3400 Spruce St, 4 Silverstein Building, Philadelphia, PA 19104-4206
1114924719 DR. HARRY BART SMELTZ 3400 Spruce St, 6 Dulles, Philadelphia, PA 19104-4206
1851399869 IRA JAY BLEIWEISS 3400 Spruce St, Philadelphia, PA 19104-4238
1316946031 JOYCE M BLOOM 3400 Spruce St, Philadelphia, PA 19104-4206
1366439705 ISSAM A MARDINI 3400 Spruce St, Hup-dulles 6, Anesthesiology Dept, Philadelphia, PA 19104-4206
1780672477 FERMIN C GARCIA 3400 Spruce St, Founders Building 9 Th Floor, Philadelphia, PA 19104-4238
1538158472 JOHN D KELLY IV 3400 Spruce St, 2 Silverstein Building, Philadelphia, PA 19104-4206
1598753469 EMMANUEL S KING 3400 Spruce St, Philadelphia, PA 19104-4206
1780673673 BARBARA A BERNHARDT 3400 Spruce St, 535 Maloney Bldg, Philadelphia, PA 19104-4206

Competitor

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City PHILADELPHIA
Zip Code 19104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.