Provider Demographics
NPI:1851697007
Name:JAORASDR, MICHAEL DEREK (APRN, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DEREK
Last Name:JAORASDR
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Gender:M
Credentials:APRN, FNP-C
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Mailing Address - Street 1:100 E CAMELBACK RD STE 108
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1061
Mailing Address - Country:US
Mailing Address - Phone:602-796-9867
Mailing Address - Fax:480-664-6153
Practice Address - Street 1:100 E CAMELBACK RD STE 108
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1061
Practice Address - Country:US
Practice Address - Phone:602-354-3925
Practice Address - Fax:602-354-3768
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2024-02-11
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Provider Licenses
StateLicense IDTaxonomies
AZ219543363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner