Individual
JENNIFER DORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1298 W FINNIE FLAT RD, CAMP VERDE, AZ 86322-5958
(928) 639-5555
(928) 639-5554
Mailing address
5317 S TATUM LN, GILBERT, AZ 85298-0356
(480) 754-9286
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
225007
AZ
Other
Enumeration date
07/01/2019
Last updated
07/23/2021
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