Provider Demographics
NPI:1891456364
Name:DUMAIS, JILL GERIANNE
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:GERIANNE
Last Name:DUMAIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16231 ONDARA
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-3755
Mailing Address - Country:US
Mailing Address - Phone:210-420-8710
Mailing Address - Fax:770-723-8817
Practice Address - Street 1:16231 ONDARA
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-3755
Practice Address - Country:US
Practice Address - Phone:210-420-8710
Practice Address - Fax:770-723-8817
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX624502163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management