Provider Demographics
NPI:1730119207
Name:COLIN, JILL K (CPM)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:K
Last Name:COLIN
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5535 MEGAN FAYE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3564
Mailing Address - Country:US
Mailing Address - Phone:702-243-0944
Mailing Address - Fax:702-645-8352
Practice Address - Street 1:5535 MEGAN FAYE ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-3564
Practice Address - Country:US
Practice Address - Phone:702-243-0944
Practice Address - Fax:702-645-8352
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife