Provider Demographics
NPI:1013883206
Name:IAMS, JILLIAN (PA-S)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:IAMS
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:BLACKBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:993 OLD BRICK RD
Mailing Address - Street 2:
Mailing Address - City:WEST ALEXANDER
Mailing Address - State:PA
Mailing Address - Zip Code:15376-2239
Mailing Address - Country:US
Mailing Address - Phone:304-559-7037
Mailing Address - Fax:
Practice Address - Street 1:208 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:WV
Practice Address - Zip Code:26074-1082
Practice Address - Country:US
Practice Address - Phone:304-336-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program