Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | PENDING | AZ |
NPI | 1134796717 |
---|---|
Provider Name | Jenna Navarro |
First Address | Phoenix, AZ 85016-7069 |
Second Address | Phoenix, AZ 85016-7069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2021 |
Last Update Date | 27/07/2021 |