Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | AP10440 | AZ |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP10440 | AZ |
NPI | 1811410715 |
---|---|
Provider Name | Jacqueline M Pinlac |
First Address | Scottsdale, AZ 85258-5036 |
Second Address | Scottsdale, AZ 85258-5036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2017 |
Last Update Date | 06/12/2020 |