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1063577161
LISA STADUM
PRESCOTT, AZ
NPI
1063577161
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AZ AP2577)
Enumeration Date
2006-12-27
Last Update Date
2011-08-17
Business Address
-- LISA STADUM NP
2100 CENTERPOINTE WEST DR
PRESCOTT, AZ 86301-8487
Phone number: 928-717-0788
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Mailing Address
-- LISA STADUM NP
2100 CENTERPOINTE WEST DR
PRESCOTT, AZ 86301-8487
Phone number: 928-717-0788
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