Individual
JEFFERY ELMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8128 EAST HWY 69, PRESCOTT VALLEY, AZ 86314
(928) 776-5463
Mailing address
7447 E SHEPHERD HILL LN, PRESCOTT VALLEY, AZ 86315-3086
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN169213
AZ
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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