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Individual

JENNIFER R CENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
6218 S 7TH ST, PHOENIX, AZ 85042-4211
(602) 243-4866
(602) 304-3132
Mailing address
4615 S 22ND ST, PHOENIX, AZ 85040-2528
(602) 232-4910
(602) 232-4917

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPO48544
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPO48544
AZ NURSING LICENSE
AZ
Enumeration date
09/04/2012
Last updated
09/04/2012
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