Provider Demographics
NPI:1477024024
Name:LESSEIG, JILL DENISE (RN)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:DENISE
Last Name:LESSEIG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 KALAKAKET ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4917
Mailing Address - Country:US
Mailing Address - Phone:907-452-4517
Mailing Address - Fax:
Practice Address - Street 1:1327 KALAKAKET ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4917
Practice Address - Country:US
Practice Address - Phone:907-452-4517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-07
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNURR18079163W00000X
AK2290872355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No163W00000XNursing Service ProvidersRegistered Nurse