Individual
LISA D TREMBLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP3663
AZ
363L00000X
Nurse Practitioner
RN139217
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
519649
—
AZ
Enumeration date
04/26/2010
Last updated
06/22/2010
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