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1770233355
AUGUSTINE JULIE PRODJINOTHO
YUMA, AZ
NPI
1770233355
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AZ 259971)
Enumeration Date
2022-03-25
Last Update Date
2022-06-13
Business Address
Ms. AUGUSTINE JULIE PRODJINOTHO
3910 S BRIANNA DR
YUMA, AZ 85365-1403
Phone number: 928-503-6643
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Mailing Address
Ms. AUGUSTINE JULIE PRODJINOTHO
2400 S AVENUE A
YUMA, AZ 85364-7170
Phone number: 928-336-1801
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