1043350846 NPI number — LAUREN MELE THORSON RN

Table of content: LAUREN MELE THORSON RN (NPI 1043350846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043350846 NPI number — LAUREN MELE THORSON RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THORSON
Provider First Name:
LAUREN
Provider Middle Name:
MELE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MELE
Provider Other First Name:
LAUREN
Provider Other Middle Name:
COLLEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043350846
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1568 S HERON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIGLEY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85236-5351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-218-5507
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 S GILBERT RD
Provider Second Line Business Practice Location Address:
GILBERT PUBLIC SCHOOLS ATTN FRANCES HOWELLS
Provider Business Practice Location Address City Name:
GILBERT
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85296-1016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-545-3826
Provider Business Practice Location Address Fax Number:
480-813-5974
Provider Enumeration Date:
02/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WS0200X , with the licence number:  RN111507 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)