MEDICARE: JILL ROSS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0170773	CO

General Provider Information

NPI Number	:	1770035826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL ROSS

Provider Business Mailing Address
First Line	:	4581 PERRY ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212
Country	:	US
Telephone Number	:	319-330-2793
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 FRANKLIN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205
Country	:	US
Telephone Number	:	303-861-3302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2016
Last Update Date	:	10/25/2016

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Directions to “ JILL ROSS ” Practice Location

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