Individual
MS. LAUREN CHARLIE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
926 E MCDOWELL RD STE 202, PHOENIX, AZ 85006-2508
(602) 609-4525
(623) 584-7194
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
(702) 838-1456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6136
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074174
—
AZ
Enumeration date
10/07/2015
Last updated
02/20/2024
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