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Individual

PENELOPE ELIZABETH LUTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, A-GNP-C

Contact information

Practice address
610 HAWTHORNE AVE SE STE 250, SALEM, OR 97301-5436
(503) 559-3312
Mailing address
2155 DALKE RIDGE DR NW, SALEM, OR 97304-4830
(503) 383-8793

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
202201833NP-PP
OR

Other

Enumeration date
02/19/2022
Last updated
02/19/2022
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