AUGUSTINE JULIE PRODJINOTHO

YUMA, AZ
NPI1770233355
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: AZ  259971)
Enumeration Date2022-03-25
Last Update Date2022-06-13
Business Address
Ms. AUGUSTINE JULIE PRODJINOTHO
3910 S BRIANNA DR
YUMA, AZ 85365-1403
Phone number: 928-503-6643
Mailing Address
Ms. AUGUSTINE JULIE PRODJINOTHO
2400 S AVENUE A
YUMA, AZ 85364-7170
Phone number: 928-336-1801