Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JERRICA PARK, PA-C
Active Sole ProprietorJERRICA PARK, PA-C is a Community/Behavioral Health healthcare provider located in FLAGSTAFF, Arizona. NPI 1245821669 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · FLAGSTAFF, AZ
Registration Details
- NPI Number
- 1245821669
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 28, 2021 (5.5688928905404 yrs)
- Last Updated
- Apr 3, 2025
- License
-
9452 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1120 W UNIVERSITY AVE STE 101FLAGSTAFF, AZ, 860012851Browse AZ providers · Browse ZIP 86001
- Phone
- 9285221300
- Fax
- 9285221301
- Primary Specialty
-
Community/Behavioral Health
251S00000X
- Additional Specialty
- Community/Behavioral Health
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.