Individual
JESSICA COLEMAN RADMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2152 S VINEYARD STE 138, MESA, AZ 85210-6882
(480) 539-6646
(480) 539-6696
Mailing address
529 OAKHOLLOW CT, BOUNTIFUL, UT 84010-3360
(180) 183-4246
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
AP11704
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP11704
ARIZONA BOARD OF NURSING- CNM LICENSE
AZ
Enumeration date
09/07/2018
Last updated
11/15/2021
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