Provider Demographics
NPI:1467852913
Name:JOSEPH-LEMON, LODZ S (CNM)
Entity Type:Individual
Prefix:
First Name:LODZ
Middle Name:S
Last Name:JOSEPH-LEMON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LODZ
Other - Middle Name:S
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:839 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2819
Mailing Address - Country:US
Mailing Address - Phone:520-792-9890
Mailing Address - Fax:520-884-9287
Practice Address - Street 1:839 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2819
Practice Address - Country:US
Practice Address - Phone:520-792-9890
Practice Address - Fax:520-884-9287
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN274199367A00000X
374J00000X
AZ257970367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ093795OtherMEDICAID