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Individual

DR. JENNESSA FAY IANNITELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
7942 W BELL RD, SUITE 2, GLENDALE, AZ 85308-8708
(480) 845-4121
Mailing address
7942 W BELL RD, SUITE 2, GLENDALE, AZ 85308-8708
(480) 845-4121

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5493
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
532518
AZ
Enumeration date
10/19/2007
Last updated
07/30/2015
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