Individual
MS. JACQUELINE ANN TUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
SKILL CENTER RD., SAN CARLOS, AZ 85550
(928) 475-2262
Mailing address
BOX 767, SAN CARLOS, AZ 85550
(928) 475-2640
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP024818
AZ
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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