Provider Demographics
NPI:1578287876
Name:ASHWORTH, LISA (FNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ASHWORTH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 E SHEA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4717
Mailing Address - Country:US
Mailing Address - Phone:804-882-7420
Mailing Address - Fax:480-951-5220
Practice Address - Street 1:5316 E SHEA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4717
Practice Address - Country:US
Practice Address - Phone:480-882-7410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ243402163WX0003X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient