Doctor Name: | LERA SAUPPE |
NPI Number: | 1083899462 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 16591 |
Business Practice Address: | 2037 Verdugo Blvd Montrose, CA - 910201626 |
Business Phone Number: | 8663892727 |
Business Fax Number: | |
Mailing Address: | 3708 Los Olivos Ln, LA CRESCENTA |
State: | CA |
Postal Code: | 912141732 |
Phone Number: | 8184841552 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2008 |
NPI Last Update Date: | 02/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 16591 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |