Individual
STEPHANIE LORRAINE JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12838 W VALENTINE AVE, EL MIRAGE, AZ 85335-8206
(623) 266-3546
Mailing address
12838 W VALENTINE AVE, EL MIRAGE, AZ 85335-8206
(623) 266-3546
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
AL8945H
AZ
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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