Provider Demographics
NPI:1891001707
Name:LAN, CARA (ND)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:
Last Name:LAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5633 S CAPTAIN KIDD CT
Mailing Address - Street 2:UNIT E
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2039
Mailing Address - Country:US
Mailing Address - Phone:480-452-7429
Mailing Address - Fax:
Practice Address - Street 1:5633 S CAPTAIN KIDD CT
Practice Address - Street 2:UNIT E
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2039
Practice Address - Country:US
Practice Address - Phone:480-452-7429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10-1179175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath