Provider Demographics
NPI:1588194963
Name:SUTTON, JENNIFER DAWN (FNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:DAWN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:DAWN
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:5281 N 99TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-2209
Mailing Address - Country:US
Mailing Address - Phone:623-516-8252
Mailing Address - Fax:623-334-4400
Practice Address - Street 1:20333 N 19TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3602
Practice Address - Country:US
Practice Address - Phone:623-516-8252
Practice Address - Fax:623-516-8253
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZF06170696363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily