Healthcare Provider Details

I. General information

NPI: 1174771620
Provider Name (Legal Business Name): JDFA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 W MEEKER BLVD
SUN CITY WEST AZ
85375-5282
US

IV. Provider business mailing address

30553 N 123RD LN
PEORIA AZ
85383-2472
US

V. Phone/Fax

Practice location:
  • Phone: 480-545-2610
  • Fax: 480-545-2673
Mailing address:
  • Phone: 480-545-2610
  • Fax: 480-545-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JANELLE MARIE DROGOWSKI
Title or Position: OWNER
Credential: NP/RNFA
Phone: 480-545-2610