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General NPI Number Information
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NPI Number | 1871176347
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Entity Type | Individual
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Provider Name | JENNIFER TATRAI
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Gender | Female
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 7975 N HAYDEN RD STE D354
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-3243
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Country | US
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Telephone | 480-694-6891
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Fax |
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Provider Business Mailing Address
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Address Line | 2835 E CORRINE DR
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City | PHOENIX
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State | AZ
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Zip | 85032-7120
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Country | US
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Telephone | 602-595-4163
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 256705
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License Number State | AZ
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