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Individual

MRS. LISA MARIE LAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C, ACNPC-AG

Contact information

Practice address
1739 E BEVERLY AVE, SUITE 203, KINGMAN, AZ 86409-3593
(928) 757-3133
Mailing address
1739 E BEVERLY AVE, SUITE 203, KINGMAN, AZ 86409-3593
(928) 757-3133

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP8621
AZ
363LF0000X
Family Nurse Practitioner
Primary
AP8621
AZ

Other

Enumeration date
04/12/2016
Last updated
01/27/2023
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