Provider Demographics
NPI:1588416085
Name:PACK-ADAIR, JAIME SUE (EDD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:SUE
Last Name:PACK-ADAIR
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E CASCADA RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4824
Mailing Address - Country:US
Mailing Address - Phone:602-531-5589
Mailing Address - Fax:
Practice Address - Street 1:510 E CASCADA RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-4824
Practice Address - Country:US
Practice Address - Phone:602-531-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider