Provider Demographics
NPI:1114435682
Name:AKINS, JILL MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:AKINS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:11855 ULYSSES ST NE STE 20
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-3949
Mailing Address - Country:US
Mailing Address - Phone:763-767-3140
Mailing Address - Fax:
Practice Address - Street 1:11855 ULYSSES ST NE STE 20
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3949
Practice Address - Country:US
Practice Address - Phone:763-767-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist