Individual
LAUREN MICHELLE NIVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3825 N 24TH ST, PHOENIX, AZ 85016-6512
(602) 955-7997
Mailing address
3825 N 24TH ST, PHOENIX, AZ 85016-6512
(602) 955-7997
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
RN177811
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP11301
AZ
Other
Enumeration date
06/25/2018
Last updated
08/18/2021
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