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Individual

LISA MUELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN BSN

Contact information

Practice address
USA MEDDAC, RWBAHC, 2240 WINROW AVE, FORT HUACHUCA, AZ 85650-7079
(520) 533-9162
(520) 533-5328
Mailing address
USA MEDDAC, RWBAHC, 2240 WINROW AVE, FORT HUACHUCA, AZ 85613-7079
(520) 533-9162
(520) 533-5328

Taxonomy

Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
RN090640
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN090640
STATE BOARD OF NURSING
AZ
Enumeration date
02/23/2016
Last updated
02/23/2016
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