Provider Demographics
NPI:1346678141
Name:SENG, JILL M (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:M
Last Name:SENG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:800 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-2514
Mailing Address - Country:US
Mailing Address - Phone:812-996-0299
Mailing Address - Fax:812-996-8497
Practice Address - Street 1:695 W 2ND ST STE 2A
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3240
Practice Address - Country:US
Practice Address - Phone:812-996-5950
Practice Address - Fax:812-996-5951
Is Sole Proprietor?:No
Enumeration Date:2013-10-15
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COPA.0004544363A00000X
IN10001594A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant