Petri, Lane Louise

Petri, Lane Louise is an individual health care provider with primary practice located at 1921 W Hospital Dr , Tucson AZ 85704-7806. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Petri, Lane Louise can be contacted via phone (520) 544-5210.

Contact Information

Primary practice address
1921 W Hospital Dr Tucson AZ 85704-7806
Phone: (520) 544-5210
Fax: (520) 544-5355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN053461 Arizona

Profile Details

NPI number 1811998644
LBN Legal business name Petri, Lane Louise
Credentials A/GNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811998644 NPPES
Arizona MEDICAID 790795

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