Provider Demographics
NPI:1720387830
Name:CONNEALY, JILL LEEANN (PA-C)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:LEEANN
Last Name:CONNEALY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3519 HIGHWAY 32
Mailing Address - Street 2:
Mailing Address - City:TEKAMAH
Mailing Address - State:NE
Mailing Address - Zip Code:68061-5095
Mailing Address - Country:US
Mailing Address - Phone:402-374-1585
Mailing Address - Fax:402-374-1612
Practice Address - Street 1:4425 COUNTY RD E
Practice Address - Street 2:
Practice Address - City:TEKAMAH
Practice Address - State:NE
Practice Address - Zip Code:68061-4004
Practice Address - Country:US
Practice Address - Phone:402-374-1585
Practice Address - Fax:402-374-1612
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2022-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE1578363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant