Individual
LANA J. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1041 S LEBARON, MESA, AZ 85210-3630
(480) 788-4628
(866) 812-0853
Mailing address
2487 S GILBERT RD STE 106-180, GILBERT, AZ 85295-2809
(480) 200-9580
(866) 812-0853
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP1740
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
787757
—
AZ
Enumeration date
05/10/2006
Last updated
12/08/2015
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