Shade, Jennifer Ann

Shade, Jennifer Ann is an sole proprietor health care provider with primary practice located at 1740 E Beverly Ave Ste B , Kingman AZ 86409-3564. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Shade, Jennifer Ann can be contacted via phone (928) 263-1335.

Contact Information

Primary practice address
1740 E Beverly Ave Ste B Kingman AZ 86409-3564
Phone: (928) 263-1335
Fax: (928) 272-0173
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X RN164008 Arizona

Profile Details

NPI number 1922645696
LBN Legal business name Shade, Jennifer Ann
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 2nd, 2019
Last updated Mar 16th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers