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NPI Code Detail

MEDICARE: JILL RALSTON APRN-FNP-C

MEDICARE: JILL RALSTON APRN-FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner025586OH

General Provider Information

NPI Number : 1043860885
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL RALSTON APRN-FNP-C
Provider Business Mailing Address
First Line : 20 LIVINGSTON AVE
Second Line :
City : DAYTON
State : OH
Zip : 45403-2938
Country : US
Telephone Number : 937-660-9052
Fax Number : 937-250-6031
Provider Business Practice Location Address
First Line : 20 LIVINGSTON AVE
Second Line :
City : DAYTON
State : OH
Zip : 45403-2938
Country : US
Telephone Number : 937-660-9052
Fax Number : 937-250-6031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2019
Last Update Date : 10/28/2025

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Directions to “ JILL RALSTON APRN-FNP-C” Practice Location

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