Provider Demographics
NPI:1588635494
Name:JOERSZ, JILL (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:JOERSZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 EAST BOULEVARD AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4234
Mailing Address - Country:US
Mailing Address - Phone:701-224-0175
Mailing Address - Fax:701-224-1285
Practice Address - Street 1:1304 EAST BOULEVARD AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4234
Practice Address - Country:US
Practice Address - Phone:701-224-0175
Practice Address - Fax:701-224-1285
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDND3655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist