Most Relevant Information
Provider Data
| NPI Number: | 1003049578 |
| Provider Name: | LIZA THOMAS CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | SP010347 |
Most Important Dates
| Enumeration Date: | 08/31/2009 |
| Last Updated: | 02/16/2024 |
Provider Practice Location
3400 CIVIC CENTER BOULEVARD
WEST PAVILION 3RD FLOOR
PHILADELPHIA
PA
191045127
Practice Location Phone/Fax
| Phone: | 2156622891 |
| Fax: |
Provider Mailing Location
3400 CIVIC CENTER BOULEVARD
WEST PAVILION 3RD FLOOR
PHILADELPHIA
PA
191045127
Provider Mailing Phone/Fax
| Phone: | 2156622891 |
| Fax: |