Provider Demographics
NPI:1710245675
Name:PERINI, JILLIAN LOUISE (CNP)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:LOUISE
Last Name:PERINI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:LOUISE
Other - Last Name:BENTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:GLICKMAN BUILDING
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:GLICKMAN BUILDING
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-7483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13251-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health