Healthcare Provider Details

I. General information

NPI: 1770434409
Provider Name (Legal Business Name): LISA ZIOMEK ACNP-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5711 E DESERT VISTA TRL
CAVE CREEK AZ
85331-6401
US

IV. Provider business mailing address

5711 E DESERT VISTA TRL
CAVE CREEK AZ
85331-6401
US

V. Phone/Fax

Practice location:
  • Phone: 602-206-5631
  • Fax:
Mailing address:
  • Phone: 602-206-5631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number334496
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: