Healthcare Provider Details

I. General information

NPI: 1477613511
Provider Name (Legal Business Name): NANCY JANE JORGENSEN RN,MS,WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 N SCOTTSDALE RD SUITE 280
SCOTTSDALE AZ
85251-5648
US

IV. Provider business mailing address

3501 N SCOTTSDALE RD SUITE 280
SCOTTSDALE AZ
85251-5648
US

V. Phone/Fax

Practice location:
  • Phone: 480-945-6583
  • Fax: 480-423-6829
Mailing address:
  • Phone: 480-945-6583
  • Fax: 480-423-6829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN102721
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP1563
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP1563
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: