Individual
JACOB WAYNE JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2728 N 24TH ST, PHOENIX, AZ 85008-1050
(844) 646-3247
Mailing address
2728 N 24TH ST, PHOENIX, AZ 85008-1050
(844) 646-3247
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
236439
AZ
Other
Enumeration date
01/13/2020
Last updated
11/17/2021
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