Healthcare Provider Details

I. General information

NPI: 1285852707
Provider Name (Legal Business Name): LORI SUE DRIGGS MSN WHCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 S. VAL VISTA DRIVE
GILBERT AZ
85297-7309
US

IV. Provider business mailing address

3815 S. VAL VISTA DRIVE
GILBERT AZ
85297-7309
US

V. Phone/Fax

Practice location:
  • Phone: 480-782-0993
  • Fax: 855-329-8939
Mailing address:
  • Phone: 480-782-0993
  • Fax: 855-329-8939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number124895
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN124895
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: