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NPI Code Detail

MEDICARE: JEANETTE MARIE HERMES RD

MEDICARE: JEANETTE MARIE HERMES RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian811566AZ

General Provider Information

NPI Number : 1760345136
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANETTE MARIE HERMES RD
Provider Business Mailing Address
First Line : 650 E INDIAN SCHOOL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-1839
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 650 E INDIAN SCHOOL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-1839
Country : US
Telephone Number : 602-277-5551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

Similar Medicare Providers

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Practice Location Address:
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1679579213 — DR. CARLOS J CARRERA M.D.
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1114928314 — MR. DANIEL PATRICK BOYLE R.PH.
Practice Location Address:
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Practice Fax:
1740278092 — MR. FRANCISCO F BALTODANO OTRL
Practice Location Address:
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Practice Fax:
1841272812 — MS. ANGELA M HEJNA PA
Practice Location Address:
650 E INDIAN SCHOOL RD , ATTENTION: ORTHOPEDIC SURGERY DEPARTMENT
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Practice Fax:
1720060288 — DR. GARY MITCHELL WEINER M.D.
Practice Location Address:
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Practice Fax:

Directions to “ JEANETTE MARIE HERMES RD” Practice Location

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