Most Relevant Information
Provider Data
| NPI Number: | 1003679846 |
| Provider Name: | JENASEE LORETTA SOUTH |
| Entity Type: | Individual |
| Taxonomy Code: | 367A00000X |
| Specialty: | Advanced Practice Midwife |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/05/2024 |
| Last Updated: | 02/05/2024 |
Provider Practice Location
14961 W BELL RD STE 175
SURPRISE
AZ
853743220
Practice Location Phone/Fax
| Phone: | 6235477205 |
| Fax: |
Provider Mailing Location
312 DEON LN
IDAHO FALLS
ID
834016466
Provider Mailing Phone/Fax
| Phone: | 2082012256 |
| Fax: |