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Krista Marie Jeddi

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

16224 S 14th Way, Phoenix, AZ 85048-4047

PECOS Enrollment

This provider is enrolled in PECOS as KRISTA JEDDI.

Based on the most recent information from CMS, provider Krista Marie Jeddi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1568151330
Provider Type
Individual
Full Name
Jeddi, Krista Marie
Title
Mrs.
Credential
FNP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
5/5/2023
Last Updated
5/5/2023

Contact Information

Practice Location

16224 S 14th Way, Phoenix, AZ 85048-4047

(602) 318-7688

Unlisted Fax

Mailing Location

16224 S 14th Way, Phoenix, AZ 85048-4047

(602) 318-7688

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 291282 Arizona

Krista Marie Jeddi

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Ashley Robinson Np

Hultgren, Patricia

Gorombei, Deborah A

Khan, Jenny R

Putt, Allison

Harris, Kelly Rae

Ruiz, Jessica Lynne

Kostov, Steli Pankova

Mcbride, Danielle Elizabeth

Swope, Amy L