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General NPI Number Information
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NPI Number | 1952308652
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Entity Type | Individual
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Provider Name | THERESA LYNN LA LUZERNE MSN , FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 10/21/2009
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Provider Practice Location Address
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Address Line | 15025 N THOMPSON PEAK PKWY
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2863
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Country | US
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Telephone | 186-682-5322
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Fax |
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Provider Business Mailing Address
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Address Line | 15127 E RIDGEWAY DR
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-4826
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP1339
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License Number State | AZ
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