Organization
LIFE JOURNEY PSYCHIATRIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LANA JEANETTE PETERSON MSN, PSYNP (OWNER)
(480) 221-5532
Entity
Organization
Contact information
Practice address
3655 E. BLUEBIRD PLACE, CHANDLER, AZ 85249
(480) 221-5532
(480) 726-3795
Mailing address
3655 E. BLUEBIRD PLACE, CHANDLER, AZ 85249
(480) 221-5532
(480) 726-3795
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN089291
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
787757
—
AZ
Enumeration date
12/21/2006
Last updated
08/22/2020
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