Provider Demographics
NPI:1811740160
Name:NORIEGA, JOCELYN PAGE (NP)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:PAGE
Last Name:NORIEGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 N ARIZOLA RD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6011
Mailing Address - Country:US
Mailing Address - Phone:520-836-3446
Mailing Address - Fax:
Practice Address - Street 1:865 N ARIZOLA RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6011
Practice Address - Country:US
Practice Address - Phone:520-836-3446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN216649163WE0003X
AZ308966363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WE0003XNursing Service ProvidersRegistered NurseEmergency