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Individual

MS. AUGUSTINE JULIE PRODJINOTHO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3910 S BRIANNA DR, YUMA, AZ 85365-1403
(928) 503-6643
Mailing address
3910 S BRIANNA DR, YUMA, AZ 85365-1403
(928) 503-6643

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
259971
AZ

Other

Enumeration date
03/25/2022
Last updated
04/22/2025
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