Provider Demographics
NPI:1184961229
Name:BROWN, JILL MARIA (DC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MARIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:MARIA
Other - Last Name:WILCOXSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4210 RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-3113
Mailing Address - Country:US
Mailing Address - Phone:913-789-9929
Mailing Address - Fax:
Practice Address - Street 1:4210 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-3113
Practice Address - Country:US
Practice Address - Phone:913-789-9929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor