Provider Demographics
NPI:1093899395
Name:CHAMBERS, JILL N
Entity Type:Individual
Prefix:MISS
First Name:JILL
Middle Name:N
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 2ND ST SW. SUITE 5134
Mailing Address - Street 2:COMDT (CG-1122) USCG
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:50593-0001
Mailing Address - Country:US
Mailing Address - Phone:616-850-2520
Mailing Address - Fax:616-850-2521
Practice Address - Street 1:COMDT CG-1122
Practice Address - Street 2:2100 2ND ST SW. S UITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:616-850-2525
Practice Address - Fax:616-850-2521
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other