Individual
MR. SCOTT ALLAN JOLLIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5430 DISTINCTION WAY, PRESCOTT, AZ 86301-8437
(928) 445-1919
Mailing address
1192 N RUSTY NAIL RD, PRESCOTT VALLEY, AZ 86314-1478
(503) 277-0265
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
200960029CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
CRNA1473
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
917333007
—
MO
Enumeration date
07/12/2007
Last updated
10/25/2023
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