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Individual

DANIELLE JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP-BC

Contact information

Practice address
: 44765 W. HATHAWAY AVE, MARICOPA, AZ 85138
(520) 788-6100
(520) 788-6140
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 381-0380
(520) 836-1826

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP7521
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011694
AZ
01
031916
MEDICARE
01
AP7521
LICENSE
AZ
01
Z168007
MEDICARE
Enumeration date
12/17/2014
Last updated
07/21/2022
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