Individual
LISA ANN MADEYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6330 W THUNDERBIRD RD, GLENDALE, AZ 85306-4002
(623) 412-4603
(623) 412-4609
Mailing address
6330 W THUNDERBIRD RD, GLENDALE, AZ 85306-4002
(623) 412-4603
(623) 412-4609
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP024139
AZ
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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