Individual
HALEY LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
10909 N PERRYVILLE RD, SURPRISE, AZ 85388-9713
(623) 876-7000
Mailing address
15608 W ACAPULCO LN, SURPRISE, AZ 85379-6225
(210) 978-6909
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
326252
TX
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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