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Individual

MS. LISA ANN ROSE WADSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MMS. PA-C

Contact information

Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5452
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5452
(480) 301-8000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2929
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
370217
AZ
Enumeration date
04/28/2008
Last updated
08/08/2016
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