Provider Demographics
NPI:1568792562
Name:KLEEMAN, JILL CHRISTY (RPH)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:CHRISTY
Last Name:KLEEMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 W GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1142
Mailing Address - Country:US
Mailing Address - Phone:520-620-1088
Mailing Address - Fax:
Practice Address - Street 1:2180 W GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-1142
Practice Address - Country:US
Practice Address - Phone:520-620-1088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS12342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist