MEDICARE: RENEE ELISE LYDIARD

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	363LF0000X	Family Nurse Practitioner	266838	AZ

General Provider Information

NPI Number	:	1144987793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE ELISE LYDIARD

Provider Business Mailing Address
First Line	:	4213 E AVALON DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7207
Country	:	US
Telephone Number	:	602-692-7810
Fax Number	:

Provider Business Practice Location Address
First Line	:	4213 E AVALON DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7207
Country	:	US
Telephone Number	:	602-692-7810
Fax Number	:

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

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	12/21/2021

Similar Medicare Providers

1952345266 — SMITHS FOOD & DRUG CENTERS INC
Practice Location Address:

2626 S 83RD AVE
PHOENIX, AZ
85043-7207

Practice Phone: 623-907-2472
Practice Fax: 623-907-0548

1679696009 — ECHOES OF HOPE
Practice Location Address:

7207 S 38TH DR
PHOENIX, AZ
85041-6103

Practice Phone: 602-682-7222
Practice Fax:

1538498712 — JENNIE LE DO RPH
Practice Location Address:

2626 S 83RD AVE
PHOENIX, AZ
85043-7207

Practice Phone: 623-907-2472
Practice Fax: 623-907-0548

1700116670 — MRS. TRAM HUE NGUYEN RPH
Practice Location Address:

2626 S 83RD AVE
PHOENIX, AZ
85043-7207

Practice Phone: 623-907-2472
Practice Fax: 623-907-0548

1386983237 — DR. CRAIG RUNBECK NMD
Practice Location Address:

7207 S 39TH AVE
PHOENIX, AZ
85041-7200

Practice Phone: 602-237-9910
Practice Fax:

1376987875 — CARISSA S ABE D.C.
Practice Location Address:

3033 N 44TH ST STE 100
PHOENIX, AZ
85018-7227

Practice Phone: 602-648-5444
Practice Fax: 602-772-3801

Directions to “ RENEE ELISE LYDIARD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.