Provider Demographics
NPI:1942797410
Name:QUITIQUIT, JILLIAN LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:LYNN
Last Name:QUITIQUIT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1106
Mailing Address - Country:US
Mailing Address - Phone:716-913-6617
Mailing Address - Fax:
Practice Address - Street 1:1815 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1106
Practice Address - Country:US
Practice Address - Phone:330-740-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00218181835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care