Individual
JODY MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4065 E BELL RD, PHOENIX, AZ 85032-2208
(602) 867-0212
Mailing address
5028 W HARMONT DR, GLENDALE, AZ 85302-6323
(623) 326-1108
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN050009
AZ
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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