Provider Demographics
NPI:1851893770
Name:UBER, JILL S (NP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:S
Last Name:UBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:S
Other - Last Name:RAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:152 FOOTE AVENUE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701
Mailing Address - Country:US
Mailing Address - Phone:716-664-5290
Mailing Address - Fax:716-664-7630
Practice Address - Street 1:152 FOOTE AVENUE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701
Practice Address - Country:US
Practice Address - Phone:716-664-5290
Practice Address - Fax:716-664-7630
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342713363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily