Provider Demographics
NPI:1821487018
Name:PEARCE, JILL MARIE (MS, CAS, LPN)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:MARIE
Last Name:PEARCE
Suffix:
Gender:F
Credentials:MS, CAS, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 FOREST MEADOW TRAIL
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1154
Mailing Address - Country:US
Mailing Address - Phone:585-739-5890
Mailing Address - Fax:
Practice Address - Street 1:36 FOREST MEADOW TRL
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1154
Practice Address - Country:US
Practice Address - Phone:585-739-5890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319644164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse