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General NPI Number Information
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NPI Number | 1609203249
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Entity Type | Individual
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Provider Name | JANICE LYNNE FAWCETT ANP
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Gender | Female
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Dates
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Enumeration Date | 09/27/2013
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Last Update Date | 08/26/2023
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Provider Practice Location Address
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Address Line | 20851 E. RITTENHOUSE RD. E103
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City | QUEEN CREEK
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State | AZ
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Zip | 85142
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Country | US
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Telephone | 480-707-1398
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Fax |
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Provider Business Mailing Address
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Address Line | 212W SUPERSTITION BLVD 101
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-4127
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Country | US
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Telephone | 480-398-1228
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Fax | 480-398-1238
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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 | AP2911
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License Number State | AZ
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