Provider Demographics
NPI:1497167928
Name:SLECHTA, JILLIAN (BSN, RN)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:SLECHTA
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9435 N BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1003
Mailing Address - Country:US
Mailing Address - Phone:330-796-9330
Mailing Address - Fax:
Practice Address - Street 1:9435 N BEDFORD RD
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-1003
Practice Address - Country:US
Practice Address - Phone:330-796-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2016-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH335355163W00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse