Provider Demographics
NPI:1568060127
Name:SQUIRES, JAMILA L
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:L
Last Name:SQUIRES
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 1:930 MARTIN LUTHER KING JR BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2656
Mailing Address - Country:US
Mailing Address - Phone:919-933-3301
Mailing Address - Fax:919-933-3375
Practice Address - Street 1:930 MARTIN LUTHER KING JR BLVD STE 202
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2656
Practice Address - Country:US
Practice Address - Phone:919-933-3301
Practice Address - Fax:919-933-3375
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL-35559163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant