Organization
BLUEFIELD MESA TELEMEDICINE HEALTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HAIRSTON FNP (AUTHORIZED OFFICIAL)
(412) 867-5519
Entity
Organization
Contact information
Practice address
18444 N 25TH AVE # 18, PHOENIX, AZ 85023-1261
(520) 605-5464
Mailing address
18444 N 25TH AVE # 18, PHOENIX, AZ 85023-1261
(520) 605-5464
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
01/27/2025
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