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NPI Code Detail

MEDICARE: LAURA ANN LICHTENWALNER

MEDICARE: LAURA ANN LICHTENWALNER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WS0200XSchool Registered NurseRN166233AZ

General Provider Information

NPI Number : 1003258492
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ANN LICHTENWALNER
Provider Business Mailing Address
First Line : 102 N PLUMER AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85719-5906
Country : US
Telephone Number : 520-225-3284
Fax Number :
Provider Business Practice Location Address
First Line : 102 N PLUMER AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85719-5906
Country : US
Telephone Number : 520-225-3284
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2013
Last Update Date : 07/25/2013

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Directions to “ LAURA ANN LICHTENWALNER ” Practice Location

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