Provider Demographics
NPI:1922512706
Name:ARENDT, JILL ANN (RN COHN)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ANN
Last Name:ARENDT
Suffix:
Gender:F
Credentials:RN COHN
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:A
Other - Last Name:ARENDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ZUCHOWSKI
Mailing Address - Street 1:1250 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3026
Mailing Address - Country:US
Mailing Address - Phone:562-437-0831
Mailing Address - Fax:
Practice Address - Street 1:412 RAWLINS DR
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-4644
Practice Address - Country:US
Practice Address - Phone:262-875-5370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI90478-30163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health