Individual
JENNIFER RAE QUEZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 W THOMAS RD STE 400, PHOENIX, AZ 85013-4238
(602) 406-4786
(916) 636-4358
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN161919
AZ
363LA2100X
Acute Care Nurse Practitioner
Primary
AP8094
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053643
—
AZ
Enumeration date
05/01/2015
Last updated
03/10/2022
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