Provider Demographics
NPI:1629468111
Name:MCGETTIGAN, JONLYN (NP)
Entity type:Individual
Prefix:
First Name:JONLYN
Middle Name:
Last Name:MCGETTIGAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOHNLYN
Other - Middle Name:
Other - Last Name:BROOME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5301 E GRANT RD
Mailing Address - Street 2:ATTN: MEDICAL STAFF
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:520-420-2560
Mailing Address - Fax:520-420-2562
Practice Address - Street 1:603 N WILMOT RD STE 151
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2701
Practice Address - Country:US
Practice Address - Phone:520-420-2560
Practice Address - Fax:520-420-2562
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN148513363LF0000X
AZAP7601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ003503Medicaid
AZZ174927Medicare PIN