Individual
MS. JENNIFER GRAHAM DURSTELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
13677 W MCDOWELL RD, GOODYEAR, AZ 85338-2618
(623) 882-1500
Mailing address
12810 S 177TH AVE, GOODYEAR, AZ 85338-5796
(480) 570-5848
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2709
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3981220
EVERCARE GROUP #
AZ
01
—
453051001
GROUP HEALTH GROUP #
AZ
05
—
762155
—
AZ
01
—
860373636
HUMANA GROUP #
AZ
01
—
AW1436
HEALTHNET GROUP #
AZ
Enumeration date
11/16/2005
Last updated
04/09/2013
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