Individual
LISA CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
11905 W COCOPAH CIR, AVONDALE, AZ 85323-6292
(623) 478-6295
Mailing address
11864 W HADLEY ST, AVONDALE, AZ 85323-9104
(602) 336-1070
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP047347
AZ
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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