Healthcare Provider Details

I. General information

NPI: 1003176777
Provider Name (Legal Business Name): JANE ELIZABETH WORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAYNE ELIZABETH WORD NP

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 04/08/2020
Certification Date: 04/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 E OSBORN RD
SCOTTSDALE AZ
85251-6432
US

IV. Provider business mailing address

1331 N 7TH ST SUITE 400
PHOENIX AZ
85006-2779
US

V. Phone/Fax

Practice location:
  • Phone: 480-583-0500
  • Fax: 480-583-2775
Mailing address:
  • Phone: 602-277-6181
  • Fax: 602-253-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP4744
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN175885
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704183149
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: