Provider Demographics
NPI:1275688418
Name:FRETTO, JACQUELINE LEA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:LEA
Last Name:FRETTO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 S DOBSON RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5602
Mailing Address - Country:US
Mailing Address - Phone:480-821-4701
Mailing Address - Fax:480-821-4708
Practice Address - Street 1:485 S DOBSON RD
Practice Address - Street 2:SUITE 111
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5602
Practice Address - Country:US
Practice Address - Phone:480-821-4701
Practice Address - Fax:480-821-4708
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN063776363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily