Provider Demographics
NPI:1306192182
Name:VARGHESE, LOVELY SIJJU (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LOVELY
Middle Name:SIJJU
Last Name:VARGHESE
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:850 PAPER MILL RD
Mailing Address - Street 2:FAIRVIEW CARE CENTER OF PAPER MILL ROAD
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7833
Mailing Address - Country:US
Mailing Address - Phone:215-233-0920
Mailing Address - Fax:215-673-1894
Practice Address - Street 1:850 PAPER MILL RD
Practice Address - Street 2:FAIRVIEW CARE CENTER OF PAPER MILL
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-7833
Practice Address - Country:US
Practice Address - Phone:215-233-0920
Practice Address - Fax:215-673-1894
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2015-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP012066363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health