Logan, Lisa M

Logan, Lisa M is an individual health care provider with primary practice located at 1501 N Campbell Ave , Tucson AZ 85724-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Logan, Lisa M can be contacted via phone (520) 694-7432.

Contact Information

Primary practice address
1501 N Campbell Ave Tucson AZ 85724-0001
Phone: (520) 694-7432
Fax: (520) 694-6688
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 090013 Arizona

Profile Details

NPI number 1902042476
LBN Legal business name Logan, Lisa M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2009
Last updated May 7th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902042476 NPPES
Arizona MEDICAID 407654

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