Jennifer Ann Shade
Jennifer Ann Shade is a Primary Care Nurse Practitioner in Kingman, Arizona. Practices as a sole proprietor. Licensed in Arizona.
- Licensed in
- AZ
- In the registry since
- 2019
Practice location Address checks out
1740 E Beverly Ave Ste BKingman, AZ 86409-3564
Phone: (928) 263-1335
Fax: (928) 272-0173
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Specialties & licences
| Primary Care Nurse Practitioner (primary) | Taxonomy 363LP2300X · Licence RN164008 (AZ) |
|---|
Record details
| NPI number | 1922645696 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | December 2, 2019 |
| Last updated in NPPES | March 16, 2024 |
| Certification date | March 16, 2024 |
| Mailing address | 1740 E Beverly Ave Ste B, Kingman, AZ 86409-3564 |
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