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Individual

MS. HEATHER SUZANNA JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MPH, MSN, CPNP

Contact information

Practice address
10750 W MCDOWELL RD, SUITE G700, AVONDALE, AZ 85392-5960
(623) 873-0321
Mailing address
10750 W MCDOWELL RD, SUITE G700, AVONDALE, AZ 85392-5960
(623) 873-0321

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP4640
AZ

Other

Enumeration date
08/31/2012
Last updated
08/31/2012
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