Individual
LORA CRITSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10436 W MARIPOSA GRANDE, PEORIA, AZ 85383-2710
(623) 210-4321
Mailing address
10436 W MARIPOSA GRANDE, PEORIA, AZ 85383-2710
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP026712
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
922147
DSC PROVIDER #
AZ
Enumeration date
06/06/2007
Last updated
07/08/2007
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