Healthcare Provider Details

I. General information

NPI: 1922936418
Provider Name (Legal Business Name): JESSICA GILLIGAN AUD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2542 E VISTOSO COMMERCE LOOP
ORO VALLEY AZ
85755-9123
US

IV. Provider business mailing address

4015 E CAMINO LLANOSO
TUCSON AZ
85718-6101
US

V. Phone/Fax

Practice location:
  • Phone: 520-825-4770
  • Fax: 520-825-4279
Mailing address:
  • Phone: 520-526-3890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberDA17231
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: