Healthcare Provider Details

I. General information

NPI: 1104432756
Provider Name (Legal Business Name): JENNIFER ALFAFARA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28635 N NORTH VALLEY PKWY
PHOENIX AZ
85085-5434
US

IV. Provider business mailing address

28635 N NORTH VALLEY PKWY
PHOENIX AZ
85085-5434
US

V. Phone/Fax

Practice location:
  • Phone: 623-582-9207
  • Fax:
Mailing address:
  • Phone: 623-582-9207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number247874
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5021998
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: