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Individual

MRS. JILLIAN MARIE MUSICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1111 RIATA VALLEY RD STE B, KINGMAN, AZ 86409-3678
(286) 925-5249
(928) 681-3977
Mailing address
1111 RIATA VALLEY RD STE B, KINGMAN, AZ 86409-3678
(928) 681-0101
(833) 989-2165

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN153255
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03D2193887
CLIA
AZ
05
460555
AZ
Enumeration date
07/06/2017
Last updated
02/02/2021
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