Provider Demographics
NPI:1952943235
Name:ABAWI, JESSICA MARIE
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MARIE
Last Name:ABAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4637 E REINS RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-9515
Mailing Address - Country:US
Mailing Address - Phone:480-200-7455
Mailing Address - Fax:
Practice Address - Street 1:2111 E PECOS RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-6072
Practice Address - Country:US
Practice Address - Phone:480-825-0593
Practice Address - Fax:480-821-6326
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN139619163WC0200X
AZTEMP240004363LF0000X
AZRNP240004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine