MEDICARE: TERRI LYNN LAUER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	244213	AZ
2	363LF0000X	Family Nurse Practitioner	244213	AZ

General Provider Information

NPI Number	:	1720954753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI LYNN LAUER

Provider Business Mailing Address
First Line	:	2427 E PLEASANT LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-5160
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2427 E PLEASANT LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-5160
Country	:	US
Telephone Number	:	480-358-8207
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2025
Last Update Date	:	01/06/2026

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Directions to “ TERRI LYNN LAUER ” Practice Location

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