Provider Demographics
NPI:1306224464
Name:DUVE, JILLIAN (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:DUVE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 REESE AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4509
Mailing Address - Country:US
Mailing Address - Phone:740-438-7421
Mailing Address - Fax:
Practice Address - Street 1:231 REESE AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4509
Practice Address - Country:US
Practice Address - Phone:740-438-7421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-09
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH367090163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse