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Individual

JASMA M DYDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-BC, CPN

Contact information

Practice address
1459 S HIGLEY RD STE 106, GILBERT, AZ 85296-5047
(480) 556-0446
Mailing address
1459 S HIGLEY RD STE 106, GILBERT, AZ 85296-5047
(480) 556-0446

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2016028863
MO
363LF0000X
Family Nurse Practitioner
Primary
242949
AZ
363LF0000X
Family Nurse Practitioner
77337
KS

Other

Enumeration date
08/05/2016
Last updated
06/24/2021
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