Provider Demographics
NPI:1710189931
Name:MOENSTER, JAMIE MICHELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:MICHELLE
Last Name:MOENSTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:698 E WETMORE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-1752
Mailing Address - Country:US
Mailing Address - Phone:520-207-3100
Mailing Address - Fax:
Practice Address - Street 1:698 E WETMORE RD STE 310
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1752
Practice Address - Country:US
Practice Address - Phone:520-207-3100
Practice Address - Fax:520-777-7634
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0060182086S0122X
OH34.008986208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery