Individual ProviderLisa NelsonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address4530 E Muirwood Dr Ste 111, Phoenix, AZ 85048-7693(480) 961-2365PECOS EnrollmentBased on the most recent information from CMS, provider Lisa Nelson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:26 AM.Profile DetailsProvider ID1255715108Provider TypeIndividualFull NameNelson, LisaTitleMrs.GenderFemaleSole ProprietorNoEnumeration Date7/9/2015Last Updated4/10/2016Contact InformationPractice LocationPractice Address4530 E Muirwood Dr Ste 111, Phoenix, AZ 85048-7693Phone(480) 961-2365FaxUnlisted FaxMailing LocationMailing Address4530 E Muirwood Dr, Ste 111, Phoenix, AZ 85048-7693Phone(480) 961-2365Fax(480) 961-2382Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP7961Arizona