Individual
MR. JONATHAN D FOSBRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
5891 W EUGIE AVE, GLENDALE, AZ 85304-1252
(602) 588-6725
Mailing address
5891 W EUGIE AVE, GLENDALE, AZ 85304-1252
(602) 588-6725
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP8420
AZ
Other
Enumeration date
01/25/2016
Last updated
12/12/2016
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