Provider Demographics
NPI:1174675169
Name:CPR FOR LIFE & HEALTH CARE CONSULTING INC.
Entity Type:Organization
Organization Name:CPR FOR LIFE & HEALTH CARE CONSULTING INC.
Other - Org Name:LEHIGH VALLEY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFIED REG. NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MSN,ND,ACNS-BC,NP
Authorized Official - Phone:908-213-8808
Mailing Address - Street 1:210 PROSPECT AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1518
Mailing Address - Country:US
Mailing Address - Phone:908-213-8808
Mailing Address - Fax:908-213-8898
Practice Address - Street 1:210 PROSPECT AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1518
Practice Address - Country:US
Practice Address - Phone:908-213-8808
Practice Address - Fax:908-213-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
26NJ0018700251300000X
NJ26NJ00018700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No251300000XAgenciesLocal Education Agency (LEA)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8978000Medicaid
NJ107704Medicare PIN
NJP65497Medicare UPIN