Provider Demographics
NPI:1912072018
Name:STEFFKE, JILL ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ANN
Last Name:STEFFKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:ANN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4240 W WEIDMAN RD
Mailing Address - Street 2:
Mailing Address - City:WEIDMAN
Mailing Address - State:MI
Mailing Address - Zip Code:48893-9717
Mailing Address - Country:US
Mailing Address - Phone:989-644-5408
Mailing Address - Fax:
Practice Address - Street 1:CENTRAL MICHIGAN UNIVERSITY HEALTH SERVICES
Practice Address - Street 2:FOUST HALL 108
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48859-0001
Practice Address - Country:US
Practice Address - Phone:989-774-1748
Practice Address - Fax:989-774-4335
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704168232163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health