Provider Demographics
NPI:1336389030
Name:BREGOVI, JILL MELISSA (RN, MSN, CPNP)
Entity Type:Individual
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First Name:JILL
Middle Name:MELISSA
Last Name:BREGOVI
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Gender:F
Credentials:RN, MSN, CPNP
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Mailing Address - Street 1:34TH STREET AND CIVIC CENTER BOULEVARD
Mailing Address - Street 2:WOOD CENTER DIVISION OF UROLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4399
Mailing Address - Country:US
Mailing Address - Phone:215-590-5754
Mailing Address - Fax:
Practice Address - Street 1:34TH STREET AND CIVIC CENTER BOULEVARD
Practice Address - Street 2:WOOD CENTER DIVISION OF UROLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4399
Practice Address - Country:US
Practice Address - Phone:215-590-5754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP010209363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics