Provider Demographics
NPI:1932490950
Name:HUFF, JILLIAN MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:MARIE
Last Name:HUFF
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1387 GERANIUM DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-8338
Mailing Address - Country:US
Mailing Address - Phone:740-644-9107
Mailing Address - Fax:
Practice Address - Street 1:1387 GERANIUM DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-8338
Practice Address - Country:US
Practice Address - Phone:740-644-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.129826-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse