Healthcare Provider Details

I. General information

NPI: 1851211353
Provider Name (Legal Business Name): JADE HENRY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4435 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7651
US

IV. Provider business mailing address

10730 N ORACLE RD UNIT 6106
ORO VALLEY AZ
85737-9318
US

V. Phone/Fax

Practice location:
  • Phone: 602-491-1997
  • Fax:
Mailing address:
  • Phone: 505-801-9350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number326314
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: