Provider Demographics
NPI:1528603511
Name:LANDS, AUDREY ELISE (PA-C)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:ELISE
Last Name:LANDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5030 S MILL AVE STE D12
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-6849
Mailing Address - Country:US
Mailing Address - Phone:480-894-2823
Mailing Address - Fax:480-756-6663
Practice Address - Street 1:5030 S MILL AVE STE D12
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6849
Practice Address - Country:US
Practice Address - Phone:480-894-2823
Practice Address - Fax:480-756-6663
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2023-02-17
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant