Provider Demographics
NPI:1962776716
Name:NP ADVANCED WOUND CARE LLC
Entity type:Organization
Organization Name:NP ADVANCED WOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CELLA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP ANP-BC WOCN
Authorized Official - Phone:215-336-8617
Mailing Address - Street 1:1635 CROATAN PL
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-5403
Mailing Address - Country:US
Mailing Address - Phone:215-336-8617
Mailing Address - Fax:215-334-5983
Practice Address - Street 1:1635 CROATAN PL
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19145-5403
Practice Address - Country:US
Practice Address - Phone:215-336-8617
Practice Address - Fax:215-334-5983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-25
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011027363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty