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General NPI Number Information
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NPI Number | 1841842879
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Entity Type | Individual
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Provider Name | JENNIFER MAXEY
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Gender | Female
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 1825 E NORTHERN AVE STE 271
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City | PHOENIX
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State | AZ
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Zip | 85020-3949
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Country | US
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Telephone | 623-271-7505
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Fax | 623-271-7502
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Provider Business Mailing Address
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Address Line | 32013 N 19TH LN
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City | PHOENIX
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State | AZ
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Zip | 85085-7096
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Country | US
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Telephone | 702-540-0753
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Fax | 623-321-8008
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 467338
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License Number State | AZ
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