Provider Demographics
NPI:1750813440
Name:MUSSET, JEANNETTE (NMD)
Entity type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:
Last Name:MUSSET
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:DR
Other - First Name:JEANNETTE
Other - Middle Name:
Other - Last Name:MUSSET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NMD
Mailing Address - Street 1:4137 E GRANADA RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4020
Mailing Address - Country:US
Mailing Address - Phone:574-252-6528
Mailing Address - Fax:
Practice Address - Street 1:13840 N NORTHSIGHT BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3665
Practice Address - Country:US
Practice Address - Phone:480-991-5092
Practice Address - Fax:480-991-2027
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17-1618175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath