Provider Demographics
NPI:1083051015
Name:PLEXICO, JILL ELAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ELAINE
Last Name:PLEXICO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-4333
Mailing Address - Country:US
Mailing Address - Phone:864-439-5000
Mailing Address - Fax:864-661-1476
Practice Address - Street 1:1005 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4333
Practice Address - Country:US
Practice Address - Phone:864-439-5000
Practice Address - Fax:864-661-1476
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23038163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse