Dutra, Jill O.

Dutra, Jill O. is an sole proprietor health care provider with primary practice located at 770 Central Ave , Dover NH 03820-3437. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Dutra, Jill O. can be contacted via phone (603) 742-0101.

Contact Information

Primary practice address
770 Central Ave Dover NH 03820-3437
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1291 New Hampshire

Profile Details

NPI number 1679098818
LBN Legal business name Dutra, Jill O.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2017
Last updated Mar 13th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679098818 NPPES
New Hampshire MEDICAID 3110787

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