Eric Jacob Hendrik Van Der Lelij
Nurse Practitioner, Family in Tucson, AZ. Individual provider (NPI-1).
NPI number1265972715
StatusActive
Last updated in NPPESDec 21, 2022
Details
- NPI
- 1265972715
- Entity type
- Individual (NPI-1)
- Name
- Eric Jacob Hendrik Van Der Lelij
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 2, 2017
- Certification date
- Dec 21, 2022
- Last updated
- Dec 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | AP9944 | AZ | Yes |
Practice location
1669 W Ina Rd Ste 101Tucson, AZ 85704-1976
Phone 520-795-6183
Mailing address
Po Box 35380Las Vegas, NV 89133-5380
Phone 520-795-6183
Other practice locations
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