Provider Demographics
NPI:1063042513
Name:FINLEY, JILLIAN ROSE (NP)
Entity Type:Individual
Prefix:MISS
First Name:JILLIAN
Middle Name:ROSE
Last Name:FINLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:JILLIAN
Other - Middle Name:ROSE
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:101 HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:IN
Mailing Address - Zip Code:46341-9117
Mailing Address - Country:US
Mailing Address - Phone:219-552-4074
Mailing Address - Fax:
Practice Address - Street 1:174 BRACKEN PKWY
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6789
Practice Address - Country:US
Practice Address - Phone:219-945-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF10191190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty