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1922645696
JENNIFER ANN SHADE
KINGMAN, AZ
NPI
1922645696
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Former Name
JENNIFER ANN GIFFIN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: AZ RN164008)
Enumeration Date
2019-12-02
Last Update Date
2024-03-16
Business Address
JENNIFER ANN SHADE
1740 E BEVERLY AVE STE B
KINGMAN, AZ 86409-3564
Phone number: 928-263-1335
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Mailing Address
JENNIFER ANN SHADE
1740 E BEVERLY AVE STE B
KINGMAN, AZ 86409-3564
Phone number: 928-263-1335
Copy
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