Individual
JESSE LAUREN PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6242 E ARBOR AVE STE 118, MESA, AZ 85206-1309
(602) 805-4914
(602) 805-4917
Mailing address
6242 E ARBOR AVE STE 118, MESA, AZ 85206-1309
(602) 805-4914
(602) 805-4917
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
327183
AZ
363LP2300X
Primary Care Nurse Practitioner
327183
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1139965
APRN
TX
01
—
327183
APRN
AZ
Enumeration date
11/29/2021
Last updated
08/15/2025
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