Jill Elizabeth Russo
Technician, Attendant Care Provider in Apache Junction, AZ. Individual provider (NPI-1).
NPI number1043372097
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1043372097
- Entity type
- Individual (NPI-1)
- Name
- Ms. Jill Elizabeth Russo
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 15, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
2017 S Thunderbird DrApache Junction, AZ 85220
Phone 480-474-1170
Mailing address
2017 S Thunderbird DrApache Junction, AZ 85220
Phone 480-474-1170
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