Provider Demographics
NPI:1982120457
Name:RAMIREZ, JENNIFFER (NP-C)
Entity type:Individual
Prefix:
First Name:JENNIFFER
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:JENNIFFER
Other - Middle Name:CANO
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9139 W THUNDERBIRD RD STE 265
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4922
Mailing Address - Country:US
Mailing Address - Phone:623-777-4567
Mailing Address - Fax:623-777-4497
Practice Address - Street 1:8139 W. THUNDERBIRD ROAD
Practice Address - Street 2:#265
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4922
Practice Address - Country:US
Practice Address - Phone:623-777-4567
Practice Address - Fax:623-777-4497
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0001861-C-NP363LF0000X
TX1171888363LF0000X
WAAP61577998363LF0000X
AZTAP10510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily