Provider Demographics
NPI:1639692106
Name:APOLINAR, LISA ANNE (DNP,FNP,BSN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANNE
Last Name:APOLINAR
Suffix:
Gender:F
Credentials:DNP,FNP,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 N DYSART RD # 459
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-3032
Mailing Address - Country:US
Mailing Address - Phone:623-935-3083
Mailing Address - Fax:
Practice Address - Street 1:2901 N CENTRAL AVE STE 160
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2702
Practice Address - Country:US
Practice Address - Phone:602-839-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine