JACQUELINE LEA AGENBROAD

PHOENIX, AZ
NPI1447222328
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: AZ  NP290)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: AZ  RN097748)
Enumeration Date2006-02-03
Last Update Date2008-06-12
Business Address
Mrs. JACQUELINE LEA AGENBROAD NP
1300 N 12TH ST SUITE 407
PHOENIX, AZ 85006-2848
Phone number: 602-239-6762
Mailing Address
Mrs. JACQUELINE LEA AGENBROAD NP
12895 W PASADENA AVE
LITCHFIELD PARK, AZ 85340
Phone number: 623-935-2373