Individual
MS. SANDRA M JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
630 N ALVERNON WAY, STE 371, TUCSON, AZ 85711-1843
(520) 319-3956
(520) 319-3913
Mailing address
2202 N FORBES BLVD, TUCSON, AZ 85745-1412
(520) 872-7265
(520) 872-7929
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1476
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115903
MEDICARE PTAN
AZ
05
—
196601
—
AZ
Enumeration date
05/26/2006
Last updated
01/28/2008
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