Healthcare Provider Details

I. General information

NPI: 1538164249
Provider Name (Legal Business Name): TJS HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S MOUNTAIN AVENUE
SPRINGERVILLE AZ
85938
US

IV. Provider business mailing address

PO BOX 639
SPRINGERVILLE AZ
85938-0639
US

V. Phone/Fax

Practice location:
  • Phone: 928-333-3353
  • Fax: 928-333-3352
Mailing address:
  • Phone: 928-333-3353
  • Fax: 928-333-3352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN076750
License Number StateAZ

VIII. Authorized Official

Name: TERESA J BECKER
Title or Position: PRESIDENT
Credential: CFNP
Phone: 928-333-3353