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General NPI Number Information
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NPI Number | 1538799234
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Entity Type | Organization
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Legal Business Name | DESERT HEIGHTS FAMILY CLINIC PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/22/2020
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 665 S LAKE POWELL BLVD
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City | PAGE
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State | AZ
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Zip | 86040-0858
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Country | US
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Telephone | 928-612-3252
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Fax | 928-415-4857
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Provider Business Mailing Address
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Address Line | PO BOX 4957
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City | PAGE
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State | AZ
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Zip | 86040-4957
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Country | US
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Telephone | 928-612-3252
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Fax | 928-415-4857
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Authorized Official
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Title or Position | FNP, CEO
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Name | MISS LORI ANN LAMMERS
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Credential | FNP-BC
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Telephone | 406-850-9247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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