Healthcare Provider Details

I. General information

NPI: 1659262368
Provider Name (Legal Business Name): ROXANNE LEE LYTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10401 W THUNDERBIRD BLVD
SUN CITY AZ
85351-3004
US

IV. Provider business mailing address

10401 W THUNDERBIRD BLVD
SUN CITY AZ
85351-3004
US

V. Phone/Fax

Practice location:
  • Phone: 623-832-4000
  • Fax:
Mailing address:
  • Phone: 623-832-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number317351
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: