Individual
LISA M CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12426 W SURREY AVE, EL MIRAGE, AZ 85335-7245
(712) 212-1327
Mailing address
12426 W SURREY AVE, EL MIRAGE, AZ 85335-7245
(712) 212-1327
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP050684
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP050684
ARIZONA BOARD OF NURSING
AZ
Enumeration date
11/27/2015
Last updated
11/27/2015
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