Provider Demographics
NPI:1851620231
Name:BARONE, JEFFREY P (DC, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:BARONE
Suffix:
Gender:M
Credentials:DC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W COOL DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-6550
Mailing Address - Country:US
Mailing Address - Phone:520-505-4494
Mailing Address - Fax:520-638-7073
Practice Address - Street 1:403 W COOL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-6550
Practice Address - Country:US
Practice Address - Phone:520-505-4494
Practice Address - Fax:520-638-7073
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7408363LF0000X, 363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ175783OtherMEDICARE PTAN
AZZ175784OtherMEDICARE PTAN
AZZ175783OtherMEDICARE PTAN
AZZ175784OtherMEDICARE PTAN