Individual
LISA MATTEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11232 N 65TH AVE, GLENDALE, AZ 85304-3640
(623) 412-4653
Mailing address
11232 N 65TH AVE, GLENDALE, AZ 85304-3640
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
257507
AZ
Other
Enumeration date
04/08/2022
Last updated
04/08/2022
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