Individual
JANNA ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18643 E ORIOLE WAY, QUEEN CREEK, AZ 85142-5540
(928) 242-4696
Mailing address
18643 E ORIOLE WAY, QUEEN CREEK, AZ 85142-5540
(928) 242-4696
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F12220690
AZ
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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