Individual
JENNY ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20044 N 68TH DR, GLENDALE, AZ 85308-5594
(623) 977-5777
Mailing address
20044 N 68TH DR, GLENDALE, AZ 85308-5594
(623) 977-5777
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP046617
AZ
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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