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General NPI Number Information
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NPI Number | 1215089883
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Entity Type | Individual
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Provider Name | AJONA DAMGAARD OLSEN ANP
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 05/21/2014
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Provider Practice Location Address
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Address Line | 3003 N CENTRAL AVE STE 800
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City | PHOENIX
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State | AZ
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Zip | 85012-2946
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Country | US
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Telephone | 480-215-0211
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Fax |
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Provider Business Mailing Address
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Address Line | 2655 W OAKGROVE LN
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City | CHANDLER
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State | AZ
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Zip | 85224-7861
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Country | US
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Telephone | 480-215-0211
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP2411
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License Number State | AZ
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