| Jillians Llc | |
|
111 Derrick Pl Hopkinsville KY 42240-1325 | |
| (270) 874-2629 | |
| Not Available |
| Full Name | Jillians Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 Derrick Pl, Hopkinsville, Kentucky |
| Authorized Official Name and Position | Jill Morgan (OWNER/OPERATOR) |
| Authorized Official Contact | 2708410834 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jillians Llc 111 Derrick Pl Hopkinsville KY 42240-1325 Ph: (270) 841-0834 | Jillians Llc 111 Derrick Pl Hopkinsville KY 42240-1325 Ph: (270) 874-2629 |
| NPI Number | 1215672514 |
|---|---|
| Provider Enumeration Date | 05/01/2022 |
| Last Update Date | 10/12/2022 |
| Medicare PECOS PAC ID | 6901274877 |
|---|---|
| Medicare Enrollment ID | O20221128000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215672514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jill Anne Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861142051 PECOS PAC ID: 9830411214 Enrollment ID: I20221128000188 |
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