Provider Demographics
NPI:1003176777
Name:WORD, JANE ELIZABETH
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ELIZABETH
Last Name:WORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAYNE
Other - Middle Name:ELIZABETH
Other - Last Name:WORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1331 N 7TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2779
Mailing Address - Country:US
Mailing Address - Phone:602-277-6181
Mailing Address - Fax:602-253-6059
Practice Address - Street 1:7400 E OSBORN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6432
Practice Address - Country:US
Practice Address - Phone:480-583-0500
Practice Address - Fax:480-583-2775
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN175885163W00000X
MI4704183149163W00000X
AZAP4744363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z1604411Medicare PIN