Provider Demographics
NPI:1124217963
Name:ZIOLKOWSKI, JILL ELIZABETH (APNP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ELIZABETH
Last Name:ZIOLKOWSKI
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
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Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:1397 S LOOP RD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-4729
Practice Address - Country:US
Practice Address - Phone:775-727-5500
Practice Address - Fax:775-727-5696
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3396033363L00000X
NV832216363LA2200X
WI140429030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1124217963Medicaid
WI711290206OtherMEDICARE PTAN
WI450030810OtherMEDICARE PTAN
NV832216OtherSTATE LICENSE