Individual
MS. LARA LYNN WOLFE SEPULVEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3864 N 27TH AVE, PHOENIX, AZ 85017-4703
(602) 685-6000
(602) 995-8503
Mailing address
3003 N CENTRAL AVE STE 200, PHOENIX, AZ 85012-2914
(602) 685-6000
(602) 302-7925
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP7265
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
974851
—
AZ
Enumeration date
10/24/2014
Last updated
12/07/2016
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