Provider Demographics
NPI:1053827733
Name:BURNETT, JILLIAN BOYLE
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:BOYLE
Last Name:BURNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:ANN
Other - Last Name:BOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:245 CAHABA VALLEY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2217
Mailing Address - Country:US
Mailing Address - Phone:205-942-6820
Mailing Address - Fax:
Practice Address - Street 1:300 ROYAL TOWER DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-6865
Practice Address - Country:US
Practice Address - Phone:205-637-0592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4548225X00000X
MD08162225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist