Individual
JORDAN BEISWANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10401 N 63RD AVE, GLENDALE, AZ 85302-1114
(623) 412-4778
Mailing address
10401 N 63RD AVE, GLENDALE, AZ 85302-1114
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R052889
SD
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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