Provider Demographics
NPI:1821361924
Name:STOCKING, JILL KRISTINE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:KRISTINE
Last Name:STOCKING
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:KRISTINE
Other - Last Name:ERDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2305 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68108-1108
Mailing Address - Country:US
Mailing Address - Phone:402-345-5683
Mailing Address - Fax:
Practice Address - Street 1:2305 S 10TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68108-1108
Practice Address - Country:US
Practice Address - Phone:402-345-5683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE278225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist