Mrs. Jacqueline L Agenbroad, NP
Nurse Practitioner in Phoenix, Arizona
1447222328- Practice location
- 1300 N 12TH St, Suite 407, Phoenix, AZ 85006-2848
- Phone
- 602-239-6762
- Fax
- 602-239-5112
- Last updated
- June 12, 2008
Mrs. Jacqueline L Agenbroad, NP is a Nurse Practitioner based in Phoenix, AZ. Mrs. Jacqueline L Agenbroad, NP holds the professional credentials of NP. The NPI number for Mrs. Jacqueline L Agenbroad, NP is 1447222328 and holds license No. RN097748 (AZ). The current practice location address is 1300 N 12TH St, Suite 407, Phoenix, AZ 85006-2848 and the office can be reached by phone at 602-239-6762 and by fax at 602-239-5112. The NPI was assigned on February 3, 2006 and the record was last updated in NPPES on June 12, 2008.
●Provider Profile Details
- NPI Number
- 1447222328
- Provider Name
- Jacqueline Lea Agenbroad
- Credential
- NP
- Entity Type
- Individual (Type 1 NPI)
- Gender
- Female
- Primary Taxonomy
- Nurse Practitioner · 363L00000X
- Sole Proprietor
- No
- Enumeration Date
- February 3, 2006
- Last Update Date
- June 12, 2008
- NPI Status
- Active
◉Business Practice Location Address
- Address
- 1300 N 12TH St
Suite 407
Phoenix, AZ 85006-2848 - City
- Phoenix
- State
- Arizona
- ZIP
- 85006-2848
- Country
- US
- Phone Number
- 602-239-6762
- Fax Number
- 602-239-5112
✉Business Mailing Address
- Address
- 12895 W Pasadena Ave
Litchfield Park, AZ 85340 - City
- Litchfield Park
- State
- AZ
- ZIP
- 85340
- Phone Number
- 623-935-2373
- Fax Number
- 623-932-4558
✎Taxonomy & License Information
| Taxonomy | Code | Primary | License | State |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | No | RN097748 | AZ |
| Nurse Practitioner | 363L00000X | Yes | NP290 | AZ |
#Other Provider Identifiers
No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.
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View all providers in Phoenix →?Frequently Asked Questions
What is the NPI number of Mrs. Jacqueline L Agenbroad, NP?
The NPI number of Mrs. Jacqueline L Agenbroad, NP is 1447222328. It was assigned on February 3, 2006 and is currently active in the NPPES registry.
What is the specialty of Mrs. Jacqueline L Agenbroad, NP?
Mrs. Jacqueline L Agenbroad, NP is registered under the primary taxonomy Nurse Practitioner (code 363L00000X) and holds license No. RN097748 (AZ).
Where does Mrs. Jacqueline L Agenbroad, NP practice?
The practice location is 1300 N 12TH St, Suite 407, Phoenix, AZ 85006-2848. The office can be reached at 602-239-6762 (phone) or 602-239-5112 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1447222328 directly on the NPPES registry website at npiregistry.cms.hhs.gov.