Individual
LISA M PAZDUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2150 GETTLER ST STE 305, DYER, IN 46311-2381
(219) 864-2630
(219) 864-2638
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71000717
IN
363L00000X
Nurse Practitioner
71000717A
IN
363LF0000X
Family Nurse Practitioner
Primary
71000717A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200286330
—
IN
05
—
200286330A
—
IN
Enumeration date
06/05/2006
Last updated
04/04/2025
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