| Doctor Name: | LISA MUELLER |
| NPI Number: | 1083073746 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN BSN |
| License Number: | RN090640 |
| Business Practice Address: | Usa Meddac, Rwbahc 2240 Winrow Ave Fort Huachuca, AZ - 856507079 |
| Business Phone Number: | 5205339162 |
| Business Fax Number: | 5205335328 |
| Mailing Address: | Usa Meddac, Rwbahc, 2240 Winrow Ave FORT HUACHUCA |
| State: | AZ |
| Postal Code: | 856137079 |
| Phone Number: | 5205339162 |
| Fax Number: | 5205335328 |
| NPI Enumeration Date: | 02/23/2016 |
| NPI Last Update Date: | 02/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | RN090640 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |