Provider Demographics
NPI:1720246630
Name:ETCHILL, NING JIN (NP)
Entity Type:Individual
Prefix:MRS
First Name:NING
Middle Name:JIN
Last Name:ETCHILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NING
Other - Middle Name:
Other - Last Name:JIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3251 KILBURN PARK CIR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-4125
Mailing Address - Country:US
Mailing Address - Phone:734-623-8032
Mailing Address - Fax:
Practice Address - Street 1:3 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MILAIN
Practice Address - State:MI
Practice Address - Zip Code:48160
Practice Address - Country:US
Practice Address - Phone:734-645-7289
Practice Address - Fax:734-439-1384
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI329600363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner