LISA ANN FEDDERSEN (NPI# 1396951901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396951901 |
| Entity Type | Individual |
| Full Name | LISA ANN FEDDERSEN |
| Credential | R.N. |
| Practice Address |
1450 S Dobson Rd Ste B324 Mesa AZ 85202-4712 |
| Mailing Address |
16824 N 51st St Scottsdale AZ 85254-1065 |
| Practice Telephone | 4808891573 |
| Practice Fax Number | 4808891574 |
| Mailing Telephone | 6026922722 |
| Mailing Fax Number | 4808891574 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WA2000X |
Registered Nurse Specialization: Administrator |
RN133209 | AZ | Nursing Service Providers |
| Street Address |
1450 S DOBSON RD STE B324 |
| City | MESA |
| State | AZ |
| Zip Code | 85202-4712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275173536 | Samuel A Wolde | Counselor | Clear View Counseling, 2651 W Guadalupe Rd, Mesa, AZ 85202 | 2020-01-14 |
| 1912549171 | Lauren Barbara Loges | Occupational Therapist | 2225 E. Southern Avenue, Mesa, AZ 85202 | 2019-10-09 |
| 1245724822 | Medsource Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1450 S Dobson Rd Ste B326, Mesa, AZ 85202 | 2018-06-18 |
| 1457843310 | Jay Douglas Baumgardner | Physical Therapist | 1941 W. Guadalupe Rd. Suite 109, Mesa, AZ 85202 | 2018-06-05 |
| 1144746215 | Alyson Fix | Physician Assistant | 1432 S Dobson Rd Ste 304, Mesa, AZ 85202 | 2017-08-20 |
| 1194108852 | Robert Dale Labrum | Counselor | 1255 W Baseline Rd Ste B-258, Mesa, AZ 85202 | 2015-06-30 |
| 1114325677 | John David Shull Jr. | Physician Assistant | 1520 S Dobson Rd Ste 305, Mesa, AZ 85202 | 2014-12-16 |
| 1316356207 | Embry Womens Health LLC | Nurse Practitioner | 2204 S Dobson Road, Suite 203, Mesa, AZ 85202 | 2014-08-05 |
| 1619312899 | Fiza Naueed Khan | Internal Medicine | 1400 South Dobson Road, Attn: Bmg Hospitalists Team/amanda Gump, Mesa, AZ 85202 | 2013-05-01 |
| 1487903373 | Jodi Lynn Mealer | Pharmacist | 1951 W. Baseline Rd., Mesa, AZ 85202 | 2012-09-06 |
| Find all providers in zip 85202 | ||||
| Taxonomy Code | 163WA2000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Administrator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376999243 | Jayme Ambrose | Registered Nurse | 2017 E Adobe St, Mesa, AZ 85213-6740 | 2016-05-10 |
| 1023255494 | Miner C Fleming | Registered Nurse | 1811 S Alma School Rd, Suite 160, Mesa, AZ 85210-3001 | 2009-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932672086 | Donka Dyer-abougou | Registered Nurse | 10950 E Fourwing Pl, Tucson, AZ 85748-3552 | 2019-01-10 |
| 1043796360 | Mckenzie Buck-friis | Registered Nurse | 1750 E Riggs Rd, Gilbert, AZ 85298-0144 | 2018-07-19 |
| 1811419534 | Cheryl Brooks | Registered Nurse | 12033 W. Agency Ave, Parker, AZ 85344 | 2017-07-14 |
| 1700253994 | Stephanie Brigham | Registered Nurse | 3011 W Cheyenne Dr, Laveen, AZ 85339-1747 | 2015-08-24 |
| 1972979508 | Julia Monroe | Registered Nurse | Hwy 163, Bldg Ka-2010, Kayenta, AZ 86033-0368 | 2015-08-18 |
| 1003237694 | Stephanie Jenkins | Registered Nurse | 14202 W Mauna Loa Ln, Surprise, AZ 85379-8669 | 2013-12-26 |
| 1598785081 | Canyon Health Care Services,inc. | Registered Nurse | 932 N Camino Seco, Tucson, AZ 85710-1708 | 2006-07-20 |
| 1205470598 | Danyashae Martinez | Registered Nurse | 11225 N 28th Dr Ste A102-22, Phoenix, AZ 85029-5606 | 2019-10-30 |
| 1255858072 | Orchid M Lopez | Registered Nurse | 4502 N Central Ave, Phoenix, AZ 85012-1817 | 2017-08-23 |
| 1417404484 | Matthew Marsh | Registered Nurse | 2240 Winrow Ave, Usa Meddac, Rwbahc, Fort Huachuca, AZ 85613 | 2016-09-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.