Provider Demographics
NPI:1124278254
Name:MORASCH, JANICE RENEE (PA)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:RENEE
Last Name:MORASCH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2945 SOUTH DOBSON RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202
Mailing Address - Country:US
Mailing Address - Phone:480-857-0222
Mailing Address - Fax:480-857-0020
Practice Address - Street 1:3645 SOUTH ROME STREET
Practice Address - Street 2:SUITE 204
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297
Practice Address - Country:US
Practice Address - Phone:480-857-0222
Practice Address - Fax:480-857-0020
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2013-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3686363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical