Provider Demographics
NPI:1487814034
Name:BROWN, JILL K
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:K
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 QUAIL RUN RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1502
Mailing Address - Country:US
Mailing Address - Phone:859-873-0037
Mailing Address - Fax:
Practice Address - Street 1:414 QUAIL RUN RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1502
Practice Address - Country:US
Practice Address - Phone:859-873-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator