Provider Demographics
NPI:1154332484
Name:NESHAM, JILL LYNNETTE (AUD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:LYNNETTE
Last Name:NESHAM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:LYNNETTE
Other - Last Name:BELSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1500 CENTER ST NE STE 102
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5500
Mailing Address - Country:US
Mailing Address - Phone:319-393-4673
Mailing Address - Fax:319-200-4068
Practice Address - Street 1:1500 CENTER ST NE STE 102
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5500
Practice Address - Country:US
Practice Address - Phone:319-393-4673
Practice Address - Fax:319-200-4068
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-001177231H00000X
IA814237700000X
IA00533231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1448704Medicaid
IAI16523Medicare ID - Type Unspecified
ILK24293Medicare ID - Type Unspecified