Individual
BRYAN KEOKE LAZARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
2111 E BASELINE RD STE F4, TEMPE, AZ 85283-1519
(602) 888-3474
(762) 212-4347
Mailing address
5223 1/2 S 5TH ST, PHOENIX, AZ 85040-8707
(602) 888-3474
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP9561
AZ
Other
Enumeration date
10/14/2016
Last updated
07/09/2025
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