Provider Demographics
NPI:1447922232
Name:FLANERY, JAMIE NICOLE (NMD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:NICOLE
Last Name:FLANERY
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8416 E CLARENDON AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-4909
Mailing Address - Country:US
Mailing Address - Phone:602-705-3284
Mailing Address - Fax:
Practice Address - Street 1:323 N LEROUX ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-4540
Practice Address - Country:US
Practice Address - Phone:928-213-5828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21-1680175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath