Provider Demographics
NPI:1639126543
Name:VERBRIDGE, JILL R (NP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:R
Last Name:VERBRIDGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-5439
Mailing Address - Country:US
Mailing Address - Phone:520-481-2668
Mailing Address - Fax:520-621-5510
Practice Address - Street 1:1224 E LOWELL ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0400
Practice Address - Country:US
Practice Address - Phone:520-481-2668
Practice Address - Fax:520-621-5510
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN067195363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner