Individual provider · Type 1 NPI
Ayesha Nicole Logan, CRNP
Psychiatric/Mental Health Nurse Practitioner · Philadelphia, PA
NPI number
1134085954
Active
Practice location
561 Fairthorne Ave
Philadelphia, PA 19128-2412
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | SP032916 (PA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1134085954
Ayesha Nicole Logan, CRNP's National Provider Identifier is 1134085954, issued on Dec 26, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Philadelphia, PA. The record was last updated on Jan 11, 2026.