Provider Demographics
NPI:1932310307
Name:STEIN, LEA MARIE (FNP)
Entity Type:Individual
Prefix:MS
First Name:LEA
Middle Name:MARIE
Last Name:STEIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5732 W SHANNON ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1859
Mailing Address - Country:US
Mailing Address - Phone:480-940-1082
Mailing Address - Fax:480-940-1082
Practice Address - Street 1:5732 W SHANNON ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-1859
Practice Address - Country:US
Practice Address - Phone:480-940-1082
Practice Address - Fax:480-940-1082
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN 053217363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily