Individual
LAUREN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7525 E BROADWAY RD STE 9, MESA, AZ 85208-1156
(480) 786-5000
Mailing address
PO BOX 20610, MESA, AZ 85277-0610
(833) 584-1347
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
208245
AZ
363L00000X
Nurse Practitioner
Primary
284981
AZ
Other
Enumeration date
10/19/2022
Last updated
05/30/2023
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