Provider Demographics
NPI:1225755994
Name:LANZ, LAUREN ELIZABETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:LANZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4143 N 35TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-4707
Mailing Address - Country:US
Mailing Address - Phone:520-331-7514
Mailing Address - Fax:
Practice Address - Street 1:3115 E INDIAN SCHOOL RD STE 13
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6807
Practice Address - Country:US
Practice Address - Phone:520-331-7514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ282109363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner