Individual
MRS. LISA MARIE BLASKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
120 E MAIN ST STE B, PAYSON, AZ 85541-5618
(928) 472-2225
(928) 468-0002
Mailing address
113 E BROWN RD, STAR VALLEY, AZ 85541-6561
(928) 472-2225
(928) 468-0002
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN152442
AZ
363LF0000X
Family Nurse Practitioner
Primary
TAP5705
AZ
Other
Enumeration date
07/07/2014
Last updated
04/29/2026
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