Provider Demographics
NPI:1457309825
Name:LAPHAN, LISA C (RN, APN- C)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:C
Last Name:LAPHAN
Suffix:
Gender:F
Credentials:RN, APN- C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 ROUTE 70 E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2117
Mailing Address - Country:US
Mailing Address - Phone:856-428-7700
Mailing Address - Fax:856-424-9120
Practice Address - Street 1:1935 ROUTE 70 E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2117
Practice Address - Country:US
Practice Address - Phone:856-428-7700
Practice Address - Fax:856-424-9120
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN09785600364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP90967Medicare UPIN
NJ070054AFDMedicare ID - Type Unspecified