Provider Demographics
NPI:1780672501
Name:LENNON, CAREY MICHELLE (ND, WHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CAREY
Middle Name:MICHELLE
Last Name:LENNON
Suffix:
Gender:F
Credentials:ND, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 W GLENMERE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-7544
Mailing Address - Country:US
Mailing Address - Phone:480-786-1177
Mailing Address - Fax:
Practice Address - Street 1:433 W. SEED FARM ROAD
Practice Address - Street 2:
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85247-2175
Practice Address - Country:US
Practice Address - Phone:520-562-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN106637363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health