LIFESPANN ENHANCED SKIN & BODY CARE PLLC NPI 1720757032

NPI Information

LIFESPANN ENHANCED SKIN & BODY CARE, PLLC is a family nurse practitioner in Gilbert, AZ. LIFESPANN ENHANCED SKIN & BODY CARE, PLLC NPI is 1720757032. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lifespann Primary Care & Esthetics.

The provider's business location address is:

2451 E BASELINE RD STE 310
GILBERT, AZ
ZIP 85234-465
Phone: (480) 351-7151
Fax: (480) 499-0891

The provider's authorized official is Jennifer Valencia Spann .
The authorized official title is Owner/manager and has the following contact phone number (480) 351-7151.

The CLIA number assigned to this NPI record is 03D2241458 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2021 and was last updated on 7/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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