Individual
JAMIE JENNETTE CORACIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5452
(480) 301-8000
Mailing address
2008 E LAGUNA DR, TEMPE, AZ 85282-5915
(480) 307-3497
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4462
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
459374
—
AZ
Enumeration date
09/08/2009
Last updated
06/07/2021
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