Smith, Jill R
Smith, Jill R is an individual health care provider with primary practice located at 550 Landmark Ave. , Bloomington IN 47403-0550. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Smith, Jill R can be contacted via phone (812) 331-3402.Contact Information
Primary practice address
550 Landmark Ave.
Bloomington IN 47403-0550
Phone: (812) 331-3402
Fax: (812) 355-6549
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 71001392A | Indiana |
Profile Details
| NPI number | 1164427076 |
|---|---|
| LBN Legal business name | Smith, Jill R |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Sep 16th, 2010 - about 14 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164427076 | NPPES |
| Indiana | MEDICAID | 200395770 |
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