Most Relevant Information
Provider Data
| NPI Number: | 1003820010 |
| Provider Name: | JANIE PARK RNFA |
| Entity Type: | Individual |
| Taxonomy Code: | 363AS0400X |
| Specialty: | Physician Assistant |
| License Number: | RN 032660 |
Most Important Dates
| Enumeration Date: | 07/27/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
604 W MEDINA AVE
MESA
AZ
852106848
Practice Location Phone/Fax
| Phone: | 4805452610 |
| Fax: | 4805452673 |
Provider Mailing Location
604 W MEDINA AVE
MESA
AZ
852106848
Provider Mailing Phone/Fax
| Phone: | 4805452610 |
| Fax: | 4805452673 |