Individual
LISETTE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
4121 E PUEBLO AVE, MESA, AZ 85206-5124
(602) 705-2307
Mailing address
2113 S NIELSON ST, GILBERT, AZ 85295-5428
(602) 705-2307
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM250
AZ
Other
Enumeration date
11/25/2021
Last updated
11/25/2021
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