Individual
MARY MACON LISSNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5259 W INDIAN SCHOOL RD STE 100, PHOENIX, AZ 85031-2651
(623) 888-5101
Mailing address
13122 N 103RD ST, SCOTTSDALE, AZ 85260-7200
(404) 550-2945
(706) 310-0390
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
272005
AZ
363LF0000X
Family Nurse Practitioner
R222059
MD
363LF0000X
Family Nurse Practitioner
RN234158
GA
Other
Enumeration date
05/07/2015
Last updated
09/15/2024
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