Provider Demographics
NPI:1578687141
Name:TOTZAUER-SMITH, LORA MAY (LVN)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:MAY
Last Name:TOTZAUER-SMITH
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 S SARANAC
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-6648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3333 E VEST AVE
Practice Address - Street 2:
Practice Address - City:HIGLEY
Practice Address - State:AZ
Practice Address - Zip Code:85236-5424
Practice Address - Country:US
Practice Address - Phone:480-279-7615
Practice Address - Fax:480-279-7515
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN166547251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care