Individual
NINA JEANETTE LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2902 W AGUA FRIA FWY STE 1090, PHOENIX, AZ 85027-3970
(602) 648-5444
(602) 772-3800
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
54603
AZ
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
54603
AZ
Other
Enumeration date
03/25/2015
Last updated
05/23/2024
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