Healthcare Provider Details
I. General information
NPI: 1376316240
Provider Name (Legal Business Name): JB MEDICAL SOLUTIONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2023
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5922 E CALLE TUBERIA
PHOENIX AZ
85018-4636
US
IV. Provider business mailing address
5922 E CALLE TUBERIA
PHOENIX AZ
85018-4636
US
V. Phone/Fax
- Phone: 480-789-0304
- Fax:
- Phone: 480-789-0304
- Fax: 602-731-8373
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULIE
BAKERMAN
Title or Position: NURSE PRACTITIONER
Credential: ACNP-BC
Phone: 480-789-0304