Provider Demographics
NPI:1003230145
Name:KOORS, JILL (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:KOORS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 83
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-1487
Mailing Address - Country:US
Mailing Address - Phone:812-662-6450
Mailing Address - Fax:
Practice Address - Street 1:955 N MICHIGAN AVE
Practice Address - Street 2:SUITE 83
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-1487
Practice Address - Country:US
Practice Address - Phone:812-662-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28188396A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily