Individual
JOSEPHINE GIBSON JETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8225 S 59TH AVE, LAVEEN, AZ 85339-2886
(602) 764-9016
Mailing address
999 E BASELINE RD APT 3105, TEMPE, AZ 85283-1307
(520) 788-0263
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP031966
AZ
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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