Healthcare Provider Details

I. General information

NPI: 1538089529
Provider Name (Legal Business Name): JENA WINGETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 E UNION HILLS DR STE D128
PHOENIX AZ
85050-3388
US

IV. Provider business mailing address

2747 S CHOLLA CIR
MESA AZ
85202-7471
US

V. Phone/Fax

Practice location:
  • Phone: 602-877-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: