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Individual

JEREMY JAMES PENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
6546 E 2ND ST STE C, PRESCOTT VALLEY, AZ 86314-3540
(928) 327-9528
(928) 327-7428
Mailing address
3165 STILLWATER DR, PRESCOTT, AZ 86305-7173
(928) 277-0875

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
322104
AZ
363LF0000X
Family Nurse Practitioner
603362
CA

Other

Enumeration date
12/13/2012
Last updated
04/11/2026
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