Provider Demographics
NPI:1457004954
Name:MFURANZIMA, JENNIFER (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MFURANZIMA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 N CRAYCROFT RD STE 120
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2829
Mailing Address - Country:US
Mailing Address - Phone:520-989-8482
Mailing Address - Fax:520-258-5498
Practice Address - Street 1:2122 N CRAYCROFT RD STE 120
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2829
Practice Address - Country:US
Practice Address - Phone:520-989-8482
Practice Address - Fax:520-258-5498
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ296082163W00000X, 163WA0400X, 163WC0400X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0400XNursing Service ProvidersRegistered NurseCase Management