MEDICARE: DREXZELL PRIMARY CARE, PLLC

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1912759226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREXZELL PRIMARY CARE, PLLC

Provider Business Mailing Address
First Line	:	6709 E 22ND ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-5110
Country	:	US
Telephone Number	:	520-565-1468
Fax Number	:	888-440-6138

Provider Business Practice Location Address
First Line	:	6709 E 22ND ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-5110
Country	:	US
Telephone Number	:	520-565-1468
Fax Number	:	888-440-6138

Authorized Official
Title or Position	:	NURSE PRACTITIONER OWNER
Name	:	DREXZELL LAANNE GLASKER
Credential	:	DNP, FNP
Telephone Number	:	520-565-1468

Provider Enumeration Date	:	04/02/2024
Last Update Date	:	03/02/2026

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