Provider Demographics
NPI:1811672512
Name:TODD, JODI M (FNP, MSN-L, RN, CCRN)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:M
Last Name:TODD
Suffix:
Gender:F
Credentials:FNP, MSN-L, RN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 W KING DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1679
Mailing Address - Country:US
Mailing Address - Phone:602-741-2004
Mailing Address - Fax:
Practice Address - Street 1:16772 W BELL RD STE 110-619
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9702
Practice Address - Country:US
Practice Address - Phone:480-531-1681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ293528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily