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1932865417
LILY INDRAWATI
SCRANTON, PA
NPI
1932865417
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: PA SP024210)
Enumeration Date
2021-11-09
Last Update Date
2021-11-09
Business Address
LILY INDRAWATI CRNP
746 JEFFERSON AVE
SCRANTON, PA 18510-1624
Phone number: 570-770-3000
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Mailing Address
LILY INDRAWATI CRNP
746 JEFFERSON AVE
SCRANTON, PA 18510-1624
Phone number:
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