Individual
MS. LORI MICHELLE LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5805 W ALAMEDA RD, GLENDALE, AZ 85310-3601
(623) 866-9446
Mailing address
5805 W ALAMEDA RD, GLENDALE, AZ 85310-3601
(623) 866-9446
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN164211
AZ
Other
Enumeration date
10/13/2019
Last updated
10/13/2019
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