Healthcare Provider Details

I. General information

NPI: 1073723078
Provider Name (Legal Business Name): JILL CATHLEEN DONIHUE CRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WERNER ST
HOT SPRINGS AR
71913-6406
US

IV. Provider business mailing address

608 PINE BLUFF ST
MALVERN AR
72104-4330
US

V. Phone/Fax

Practice location:
  • Phone: 501-609-4300
  • Fax:
Mailing address:
  • Phone: 501-332-4053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: