Organization
IDEFY MEDICAL AESTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETHANY LYNN JAMESON FNP (OWNER/CEO)
(480) 414-8941
Entity
Organization
Contact information
Practice address
1324 N FARRELL CT STE 109, GILBERT, AZ 85233-1945
(480) 414-8941
Mailing address
22620 S 178TH PL, GILBERT, AZ 85298-8934
(480) 414-8941
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10272
AZ
Other
Enumeration date
08/15/2017
Last updated
10/08/2023
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