Individual
JORDAN RILEY JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(480) 500-2540
(623) 201-7954
Mailing address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(320) 360-6191
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5295
AZ
Other
Enumeration date
10/31/2012
Last updated
11/28/2019
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