Provider Demographics
NPI:1578890794
Name:NUTT, JILL (RDMS)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:NUTT
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W CHANDLER BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6153
Mailing Address - Country:US
Mailing Address - Phone:480-726-9300
Mailing Address - Fax:480-726-9301
Practice Address - Street 1:1600 W CHANDLER BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6153
Practice Address - Country:US
Practice Address - Phone:480-726-9300
Practice Address - Fax:480-726-9301
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography