Provider Demographics
NPI:1093046930
Name:RUDLOFF, JILL A (RN)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:A
Last Name:RUDLOFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3146 E WIER AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-2754
Mailing Address - Country:US
Mailing Address - Phone:602-232-4200
Mailing Address - Fax:602-243-2115
Practice Address - Street 1:3146 E WIER AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-2754
Practice Address - Country:US
Practice Address - Phone:602-232-4200
Practice Address - Fax:602-243-2115
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51375163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse