Individual
JENNIFER MARIE IVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
711 E MISSOURI AVE STE 110, PHOENIX, AZ 85014-2824
(602) 604-0548
Mailing address
711 E MISSOURI AVE STE 110, PHOENIX, AZ 85014-2824
(602) 604-0548
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP035815
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP035815
LPN
AZ
Enumeration date
05/01/2008
Last updated
05/01/2008
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