Provider Demographics
NPI:1043476591
Name:CAVAZOS, LORENA PATRICIA (CNM)
Entity Type:Individual
Prefix:MS
First Name:LORENA
Middle Name:PATRICIA
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2702 N. 3RD ST.
Mailing Address - Street 2:STE. 4020
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1130
Mailing Address - Country:US
Mailing Address - Phone:602-323-3242
Mailing Address - Fax:602-323-3496
Practice Address - Street 1:635 E. BASELINE RD.
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042
Practice Address - Country:US
Practice Address - Phone:602-243-7277
Practice Address - Fax:602-243-1235
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ176B00000X
AZRN154011/ AP3126367A00000X
AZRN154011367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife