| Doctor Name: | MRS. LISA MARIE BLASKO |
| NPI Number: | 1245646629 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | RN152442 |
| Business Practice Address: | 620 Lee St Winslow, AZ - 860472435 |
| Business Phone Number: | 9282892000 |
| Business Fax Number: | |
| Mailing Address: | 620 Lee St, WINSLOW |
| State: | AZ |
| Postal Code: | 860472435 |
| Phone Number: | 9282892000 |
| Fax Number: | |
| NPI Enumeration Date: | 07/07/2014 |
| NPI Last Update Date: | 07/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | RN152442 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |