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Organization
ELITE MEDICAL PARTNERS PLLC
Active
Organization
ELITE MEDICAL PARTNERS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN TRULSON PA-C (OWNER)
(480) 227-6683
Entity
Organization
Contact information
Practice address
20261 E OCOTILLO RD STE 110, QUEEN CREEK, AZ 85142-8806
(480) 805-1444
(480) 677-2768
Mailing address
20261 E OCOTILLO RD STE 110, QUEEN CREEK, AZ 85142-8806
(480) 805-1444
(480) 677-2768
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104324623
NPI
—
01
—
12763749
CAQH
—
01
—
14949926
CAQH
—
Enumeration date
08/17/2020
Last updated
07/22/2021
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