JENNIFER ANN SHADE NPI 1922645696

NPI Information

Jennifer Ann Shade is a primary care nurse practitioner in Kingman, AZ with 5 years of experience. Jennifer Ann Shade NPI is 1922645696. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1740 E BEVERLY AVE STE B
KINGMAN, AZ
ZIP 86409-564
Phone: (928) 263-1335
Fax: (928) 272-0173

The NPI 1922645696 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/2/2019 and was last updated on 3/16/2024.

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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