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Individual

JENASEE LORETTA SOUTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14961 W BELL RD STE 175, SURPRISE, AZ 85374-3220
(623) 547-7205
Mailing address
312 DEON LN, IDAHO FALLS, ID 83401-6466
(208) 201-2256

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary

Other

Enumeration date
02/05/2024
Last updated
02/05/2024
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