Individual
RENEE JEANINE PRIVETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2121 W CHANDLER BLVD, STE 110, CHANDLER, AZ 85224-6545
(480) 963-2233
(480) 963-2277
Mailing address
2121 W CHANDLER BLVD, STE 110, CHANDLER, AZ 85224-6545
(480) 963-2233
(480) 963-2277
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2700
AZ
363AM0700X
Medical Physician Assistant
2700
AZ
363AS0400X
Surgical Physician Assistant
2700
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3Z3974
HEALTHNET
AZ
05
—
501958
—
AZ
Enumeration date
01/27/2009
Last updated
11/24/2015
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