Provider Demographics
NPI:1396043493
Name:ZASKE, JILL MARIE (NP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:ZASKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 WILLOWDALE CT
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-4737
Mailing Address - Country:US
Mailing Address - Phone:810-720-5130
Mailing Address - Fax:810-720-4661
Practice Address - Street 1:1345 WILLOWDALE CT
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4737
Practice Address - Country:US
Practice Address - Phone:810-720-4130
Practice Address - Fax:810-720-4661
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257205363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner