Individual
DEEPTHY JOLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4204 W CACTUS RD, PHOENIX, AZ 85029-2924
(602) 547-5919
Mailing address
5542 W CAVEDALE DR, PHOENIX, AZ 85083-6369
(623) 337-1146
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP8609
AZ
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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