| Doctor Name: | MS. JO ANN FORRISTAL |
| NPI Number: | 1003854605 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CFNP |
| License Number: | 098041 |
| Business Practice Address: | 3735 Hway 95 Bullhead City, AZ - 864428199 |
| Business Phone Number: | 9284441444 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1270, CORNVILLE |
| State: | AZ |
| Postal Code: | 863251270 |
| Phone Number: | 3144123791 |
| Fax Number: | |
| NPI Enumeration Date: | 06/04/2006 |
| NPI Last Update Date: | 11/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 098041 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |