Individual
JUNIPER DERY-CHAFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1515 E OSBORN RD, PHOENIX, AZ 85014-5309
(602) 604-0000
Mailing address
1241 W KNOX PL, TUCSON, AZ 85705-2505
(520) 465-7259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6500
AZ
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
6500
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6500
STATE OF ARIZONA LICENSE
AZ
Enumeration date
10/03/2016
Last updated
11/21/2024
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