Individual
MISS NICOLE RENEE JORGENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5133 N CENTRAL AVE STE 206, PHOENIX, AZ 85012-1438
(602) 264-0608
(602) 234-0417
Mailing address
PO BOX 910221, DALLAS, TX 75391-0221
(520) 519-7700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3806
AZ
Other
Enumeration date
01/22/2008
Last updated
03/07/2023
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