Individual
MR. JEREMIAH EUGENE TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AG-ACNPC
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 249-0212
Mailing address
6115 W NORTH LN, GLENDALE, AZ 85302-1246
(602) 888-2662
(602) 887-5756
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN172376
AZ
363LA2100X
Acute Care Nurse Practitioner
Primary
AP11167
AZ
Other
Enumeration date
03/12/2018
Last updated
10/25/2023
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