Individual
LISA ANN FEDDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1450 S DOBSON RD STE B324, MESA, AZ 85202-4712
(480) 889-1573
(480) 889-1574
Mailing address
16824 N 51ST ST, SCOTTSDALE, AZ 85254-1065
(602) 692-2722
(480) 889-1574
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN133209
AZ
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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