Individual
JETTA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
2018 E AVENIDA DEL SOL, PHOENIX, AZ 85024-8601
(602) 717-3731
Mailing address
2018 E AVENIDA DEL SOL, PHOENIX, AZ 85024-8601
(602) 717-3731
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
16060006
AZ
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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