Individual provider Active NPI

Jean Marsalla, ANP

  • Adult Health Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1043293475
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN045422 Issued in AZ
Practice address
1775 E Skyline Dr
Ste 101
Tucson, AZ 85718-1162
Phone
(520) 615-6200
Fax
(520) 615-6255
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN045422 AZ Primary

Addresses

Primary practice location

1775 E Skyline Dr
Ste 101
Tucson, AZ 85718-1162

Mailing address

1775 E Skyline Dr
Ste 101
Tucson, AZ 85718-1162
Phone (520) 615-6200

Other identifiers 1

IdentifierTypeStateIssuer
452491MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1043293475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 E SKYLINE DR",
            "address_2": "STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181162",
            "telephone_number": "520-615-6200",
            "fax_number": "520-615-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 E SKYLINE DR",
            "address_2": "STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857181162",
            "telephone_number": "520-615-6200",
            "fax_number": "520-615-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSALLA",
        "first_name": "JEAN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN045422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "452491",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.