Provider Demographics
NPI:1700095213
Name:NERIO, JILL DANIELLE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:DANIELLE
Last Name:NERIO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:DANIELLE
Other - Last Name:SCHNEPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:5830 S RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-4224
Mailing Address - Country:US
Mailing Address - Phone:918-551-7043
Mailing Address - Fax:
Practice Address - Street 1:800 TUCKER DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-9700
Practice Address - Country:US
Practice Address - Phone:918-631-5228
Practice Address - Fax:918-631-3057
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK329OtherLAT