Individual
JILL TSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
CORNER OF ROUTES N12 & N7, B 649, FORT DEFIANCE, AZ 86504
(505) 879-0721
Mailing address
PO BOX 2271, FORT DEFIANCE, AZ 86504-2271
(505) 879-0721
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
RN78942
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
AZ
Enumeration date
11/10/2022
Last updated
11/10/2022
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