Basic Information
| Provider Information | |||||||||
| NPI: | 1154664068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMEEN | ||||||||
| FirstName: | JAMEELA | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 91933 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857521933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5209754883 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3750 ROHNERVILLE RD | ||||||||
| Address2: | |||||||||
| City: | FORTUNA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955403118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077256101 | ||||||||
| FaxNumber: | 7077252978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2013 | ||||||||
| LastUpdateDate: | 03/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 95008616 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | AP4903 | AZ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | F0313111 | 01 | AZ | AMERICAN ACADEMY OF NURSE PRACTIONERS FNP CERTIFICATION | OTHER |