Individual
CARMEN LERVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11022 S 51ST ST STE 250, PHOENIX, AZ 85044-4319
(480) 939-6137
Mailing address
11022 S 51ST ST STE 250, PHOENIX, AZ 85044-4319
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN172593
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
278253
AZ
Other
Enumeration date
07/17/2022
Last updated
08/15/2022
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