Individual provider · Type 1 NPI
Jacqueline Lea Agenbroad, NP
Nurse Practitioner · Phoenix, AZ
Practice location
1300 N 12th St, Suite 407
Phoenix, AZ 85006-2848
Fax (602) 239-5112
Mailing address
12895 W Pasadena Ave
Litchfield Park, AZ 85340
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | RN097748 (AZ) |
| Nurse Practitioner Primary | 363L00000X | NP290 (AZ) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1447222328
Jacqueline Lea Agenbroad, NP's National Provider Identifier is 1447222328, issued on Feb 3, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Phoenix, AZ. The record was last updated on Jun 12, 2008.