JACKSON WADE MCQUEEN NPI 1780341032

NPI Information

Jackson Wade Mcqueen is a student in an organized health care education training program in Phoenix, AZ. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Jackson Wade Mcqueen NPI is 1780341032. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3300 W CAMELBACK RD # A21367
PHOENIX, AZ
ZIP 85017-030
Phone: (325) 977-1914

The enumeration date for this NPI number is 11/22/2021 and was last updated on 11/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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