Provider Demographics
NPI:1164186615
Name:NEVORSKI, JILL MARIE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:MARIE
Last Name:NEVORSKI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7874 ALLISON DR
Mailing Address - Street 2:
Mailing Address - City:ALMONT
Mailing Address - State:MI
Mailing Address - Zip Code:48003-8714
Mailing Address - Country:US
Mailing Address - Phone:586-291-8549
Mailing Address - Fax:
Practice Address - Street 1:147 N ALMONT AVE
Practice Address - Street 2:
Practice Address - City:IMLAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48444-1002
Practice Address - Country:US
Practice Address - Phone:810-721-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704278525207Q00000X
MI47042748525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine