Healthcare Provider Details

I. General information

NPI: 1528851656
Provider Name (Legal Business Name): ARLENE JASMINE LOTHIAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5041 W NORTHERN AVE STE B
GLENDALE AZ
85301-1539
US

IV. Provider business mailing address

7185 W WILLOW AVE
PEORIA AZ
85381-6063
US

V. Phone/Fax

Practice location:
  • Phone: 623-455-1501
  • Fax:
Mailing address:
  • Phone: 623-455-1501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN171015
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN171015
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License NumberRN171015
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberRN171015
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: