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1639684046
LAURA E DIETRICH-LAKE
PHOENIX, AZ
NPI
1639684046
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AZ AP10869)
Enumeration Date
2017-12-07
Last Update Date
2018-03-17
Business Address
LAURA E DIETRICH-LAKE FNP-C
4707 N 12TH ST
PHOENIX, AZ 85014-4009
Phone number: 602-344-2506
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Mailing Address
LAURA E DIETRICH-LAKE FNP-C
2929 E THOMAS RD
PHOENIX, AZ 85016-8034
Phone number: 602-470-5000
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