Provider Demographics
NPI:1326273368
Name:LAMBERT, LAURA M (NMD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 W KEATING AVE #412
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-8520
Mailing Address - Country:US
Mailing Address - Phone:480-766-0710
Mailing Address - Fax:
Practice Address - Street 1:5416 E SOUTHERN AVE STE 110
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-985-0000
Practice Address - Fax:480-985-0029
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ09-1107OtherNPBOMEX - LICENSE TO PRACTICE MEDICINE