Provider Demographics
NPI:1902091556
Name:ONEAL, LISA MARIE (WHNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:ONEAL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 N 183RD AVE
Mailing Address - Street 2:
Mailing Address - City:WADDELL
Mailing Address - State:AZ
Mailing Address - Zip Code:85355-9830
Mailing Address - Country:US
Mailing Address - Phone:623-238-5313
Mailing Address - Fax:
Practice Address - Street 1:1661 E CAMELBACK RD
Practice Address - Street 2:SUITE 160
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3911
Practice Address - Country:US
Practice Address - Phone:602-241-1671
Practice Address - Fax:602-230-7982
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2789363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health