Individual
JESSYCA ANN SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1511
(602) 263-1619
Mailing address
B0X PO, PASADENA, CA 91110-0698
(602) 263-1511
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN142105
AZ
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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