Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Laura E Dietrich-Lake, FNP-C

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1639684046

Laura E Dietrich-Lake, FNP-C is a Nurse Practitioner in Phoenix, Arizona. Qualified in 2017, 9 years ago. Practices with District Medical Group Inc, a 450-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
9
Licensed in
AZ
In the registry since
2017
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4707 N 12th St
Phoenix, AZ 85014-4009
Phone: (602) 344-2506
Fax: (602) 247-9506
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3555 S Val Vista Dr, Gilbert, AZ 85297-7323 — (480) 728-8000
  • 3555 S Val Vista Dr, Gilbert, AZ 85297-7323 — (480) 728-8000

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence AP10869 (AZ)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence AP10869 (AZ)

Record details

NPI number1639684046
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedDecember 7, 2017
Last updated in NPPESJanuary 27, 2026
Certification dateJanuary 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice District Medical Group Inc — 450 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Phoenix