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General NPI Number Information
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NPI Number | 1588138556
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Entity Type | Individual
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Provider Name | JILL R WEIDEMAN ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 8901 E RAINTREE DR STE 150
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-7110
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Country | US
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Telephone | 480-733-7600
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Fax | 602-805-2816
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Provider Business Mailing Address
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Address Line | 8901 E RAINTREE DR STE 150
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-7110
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Country | US
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Telephone | 480-733-7600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A112235
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 301837
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License Number State | AZ
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