Provider Demographics
NPI:1740354125
Name:GREENFIELD, JACQUELINE B (NMD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:B
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1387
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-1387
Mailing Address - Country:US
Mailing Address - Phone:480-930-2939
Mailing Address - Fax:
Practice Address - Street 1:NORTH VALLEY MEDICAL CENTER
Practice Address - Street 2:7301 E SUNDANCE TRAIL C-102
Practice Address - City:CAREFREE
Practice Address - State:AZ
Practice Address - Zip Code:85377
Practice Address - Country:US
Practice Address - Phone:480-284-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25-003397171100000X
AZ98-126175F00000X, 175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20-0446029OtherFEDERAL ID