Provider Demographics
NPI:1821131202
Name:JAPAN, JILL NMI (RN)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:NMI
Last Name:JAPAN
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 1:5225 E BUENA SCHOOL BLVD
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2392
Mailing Address - Country:US
Mailing Address - Phone:520-515-2872
Mailing Address - Fax:
Practice Address - Street 1:5225 E BUENA SCHOOL BLVD
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2392
Practice Address - Country:US
Practice Address - Phone:520-515-2872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN086986163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool