Provider Demographics
NPI:1982351987
Name:NAYLOR, JILLIAN (LPN)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:NAYLOR
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 1:101 MARLBOROUGH ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-1517
Mailing Address - Country:US
Mailing Address - Phone:401-744-3532
Mailing Address - Fax:
Practice Address - Street 1:101 MARLBOROUGH ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-1517
Practice Address - Country:US
Practice Address - Phone:401-744-3532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILPN12493164W00000X
MALN99731164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse