Individual ProviderJeremy Lee GianzeroRegistered NurseNursing Service ProvidersPractice Address4212 N 16th St, Phoenix Indian Medicial Center, Phoenix, AZ 85016-5319(602) 263-1200(602) 213-1200PECOS EnrollmentBased on the most recent information from CMS, provider Jeremy Lee Gianzero does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1417218595Provider TypeIndividualFull NameGianzero, Jeremy LeeCredentialRNGenderMaleSole ProprietorNoEnumeration Date6/5/2012Last Updated6/5/2012Contact InformationPractice LocationPractice Address4212 N 16th St, Phoenix Indian Medicial Center, Phoenix, AZ 85016-5319Phone(602) 263-1200Fax(602) 200-5383Mailing LocationMailing AddressPO Box 31001-0698, Pasadena, CA 91110-0698Phone(602) 213-1200Fax(602) 200-5383Provider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense186628Colorado