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Individual

LORENA A CONDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2727 W BASELINE RD, SUITE 8, TEMPE, AZ 85283-1067
(602) 323-0904
(602) 243-7616
Mailing address
2727 W BASELINE RD, SUITE 8, TEMPE, AZ 85283-1067
(602) 323-0904
(602) 243-7616

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4992
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4992
LICENSE
AZ
Enumeration date
12/19/2011
Last updated
05/09/2012
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