| Doctor Name: | MS. JEANETTE DAY JICHA |
| NPI Number: | 1164646063 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | AP3761 |
| Business Practice Address: | 811 N Tegner St Suite 113 Wickenburg, AZ - 853905409 |
| Business Phone Number: | 8778095092 |
| Business Fax Number: | |
| Mailing Address: | 9520 W Palm Ln, Suite 200 PHOENIX |
| State: | AZ |
| Postal Code: | 850374403 |
| Phone Number: | 8778095092 |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 04/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP3761 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |