Gaylord, Jessica H

Gaylord, Jessica H is an individual health care provider with primary practice located at 2920 N 4Th St , Flagstaff AZ 86004-1816. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gaylord, Jessica H can be contacted via phone (928) 233-5110.

Contact Information

Primary practice address
2920 N 4Th St Flagstaff AZ 86004-1816
Phone: (928) 233-5110
Fax: (928) 774-4808
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP2537 Arizona

Profile Details

NPI number 1861546384
LBN Legal business name Gaylord, Jessica H
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2007
Last updated Oct 21st, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861546384 NPPES
Arizona MEDICAID 418354

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