Organization
LEGACY PRIMARY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMEELA AMEEN FNP (SOLE MEMBER)
(520) 971-7781
Entity
Organization
Contact information
Practice address
77 CALLE PORTAL STE B260A, SIERRA VISTA, AZ 85635-2998
(520) 226-4338
(866) 337-8432
Mailing address
7202 W ROMERO POOLS PL, TUCSON, AZ 85743-5540
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP4903
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
803226
—
AZ
Enumeration date
01/05/2016
Last updated
01/05/2016
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