Provider Demographics
NPI:1992038954
Name:PELZER, JO ANN (RN)
Entity Type:Individual
Prefix:
First Name:JO ANN
Middle Name:
Last Name:PELZER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N AMARILLO ST
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-3656
Mailing Address - Country:US
Mailing Address - Phone:520-836-6694
Mailing Address - Fax:520-421-0423
Practice Address - Street 1:1000 N AMARILLO ST
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-3656
Practice Address - Country:US
Practice Address - Phone:520-836-6694
Practice Address - Fax:520-421-0423
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN042976163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool