Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jennifer Ann Shade

Individual provider Primary Care Nurse Practitioner · NPI 1922645696

Jennifer Ann Shade is a Primary Care Nurse Practitioner in Kingman, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2019

Practice location Address checks out

1740 E Beverly Ave Ste B
Kingman, AZ 86409-3564
Phone: (928) 263-1335
Fax: (928) 272-0173
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence RN164008 (AZ)

Record details

NPI number1922645696
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 2, 2019
Last updated in NPPESMarch 16, 2024
Certification dateMarch 16, 2024

Other providers in Kingman