Provider Demographics
NPI:1689227506
Name:GARCIA, JERI LYNN (FNP-C)
Entity Type:Individual
Prefix:
First Name:JERI
Middle Name:LYNN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11888 N RAPHAEL WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-6613
Mailing Address - Country:US
Mailing Address - Phone:520-312-0901
Mailing Address - Fax:
Practice Address - Street 1:11888 N RAPHAEL WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-6613
Practice Address - Country:US
Practice Address - Phone:520-312-0901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ228317363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily