Individual
JILLIAN BLAIR TRULSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20261 E OCOTILLO RD, QUEEN CREEK, AZ 85142-8806
(480) 677-2771
Mailing address
430 N GRANITE ST, GILBERT, AZ 85234-4834
(480) 227-6683
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7017
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14949926
CAQH
—
Enumeration date
01/30/2018
Last updated
11/08/2021
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