Individual
JESSICA NICOLE FONG DUTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-0990
Mailing address
2108 E THOMAS RD, PHOENIX, AZ 85016-7761
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
261973
AZ
Other
Enumeration date
03/18/2021
Last updated
12/30/2024
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