Provider Demographics
NPI:1487613873
Name:KILGORE-CHRISTENSEN, LISA NOWELL (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:NOWELL
Last Name:KILGORE-CHRISTENSEN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:650 E INDIAN SCHOOL RD
Mailing Address - Street 2:CARL T HAYDEN VA MEDICAL CENTER
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1839
Mailing Address - Country:US
Mailing Address - Phone:602-277-5551
Mailing Address - Fax:602-222-6493
Practice Address - Street 1:650 E INDIAN SCHOOL RD
Practice Address - Street 2:CARL T HAYDEN VA MEDICAL CENTER
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1839
Practice Address - Country:US
Practice Address - Phone:602-277-5551
Practice Address - Fax:602-222-6493
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZ2435363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant