Provider Demographics
NPI:1922443639
Name:BURGIN, JILL M (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:M
Last Name:BURGIN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:883 A MIKELL DRIVE
Mailing Address - Street 2:STILES POINT ELEMENTARY
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-5042
Mailing Address - Country:US
Mailing Address - Phone:843-406-6050
Mailing Address - Fax:843-762-2773
Practice Address - Street 1:883 MIKELL DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-5042
Practice Address - Country:US
Practice Address - Phone:843-762-2767
Practice Address - Fax:843-762-2773
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC58560163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool