Provider Demographics
NPI:1790452399
Name:WU, JAMIE ANN (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:ANN
Last Name:WU
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85607-2413
Mailing Address - Country:US
Mailing Address - Phone:520-364-1120
Mailing Address - Fax:
Practice Address - Street 1:1906 E 11TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-2413
Practice Address - Country:US
Practice Address - Phone:520-364-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ262814207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine