Healthcare Provider Details

I. General information

NPI: 1871052902
Provider Name (Legal Business Name): JAMIE KERIN JEREMIE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10420 N LA CANADA DR STE 120
ORO VALLEY AZ
85737-7025
US

IV. Provider business mailing address

261 N ROOSEVELT AVE
CHANDLER AZ
85226-2617
US

V. Phone/Fax

Practice location:
  • Phone: 480-677-8282
  • Fax: 888-316-1686
Mailing address:
  • Phone: 480-677-8282
  • Fax: 888-316-1686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number250278
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: