# DR. MIREILLE JOSEPH JEROME

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1174378673
- **Gender:** F
- **Credential:** MD- PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 10398 | AZ | Yes |
| 363AM0700X | Medical Physician Assistant | 1780 | PR | — |

## Other

- **Enumeration date:** 04/19/2024
- **Last updated:** 09/29/2024