MEDICARE: LAUREN MARIE PIZARRO APRN, RN

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
1	363L00000X	Nurse Practitioner	TBD	UT

General Provider Information

NPI Number	:	1093488595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MARIE PIZARRO APRN, RN

Provider Business Mailing Address
First Line	:	3286 JACKSON AVE
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84403-0724
Country	:	US
Telephone Number	:	208-899-9996
Fax Number	:

Provider Business Practice Location Address
First Line	:	5926 FASHION POINT DR
Second Line	:
City	:	SOUTH OGDEN
State	:	UT
Zip	:	84403-4541
Country	:	US
Telephone Number	:	208-899-9996
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2021
Last Update Date	:	07/29/2021

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