Provider Demographics
NPI:1538190269
Name:LASETER, DEBRA (NP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:LASETER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 N 44TH ST
Mailing Address - Street 2:SUITE #200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-3293
Mailing Address - Country:US
Mailing Address - Phone:602-424-4204
Mailing Address - Fax:602-952-7146
Practice Address - Street 1:2255 N 44TH ST
Practice Address - Street 2:SUITE #200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-3293
Practice Address - Country:US
Practice Address - Phone:602-424-4204
Practice Address - Fax:602-952-7146
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZNP302363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health