Provider Demographics
NPI:1649882820
Name:CONNELL, JILL D (ARNP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:D
Last Name:CONNELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:D
Other - Last Name:SPEICHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:507 SUNSET PL
Mailing Address - Street 2:
Mailing Address - City:CHARLES CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50616-1634
Mailing Address - Country:US
Mailing Address - Phone:319-215-8252
Mailing Address - Fax:
Practice Address - Street 1:1501 S MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:CHARLES CITY
Practice Address - State:IA
Practice Address - Zip Code:50616-3444
Practice Address - Country:US
Practice Address - Phone:641-228-5151
Practice Address - Fax:641-228-2902
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA159256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily