Healthcare Provider Details

I. General information

NPI: 1952854309
Provider Name (Legal Business Name): JILL ELAINE PRATHER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL MCCURDY

II. Dates (important events)

Enumeration Date: 08/02/2016
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WESTON RD
WESTON FL
33331-3602
US

IV. Provider business mailing address

3100 WESTON RD
WESTON FL
33331-3602
US

V. Phone/Fax

Practice location:
  • Phone: 216-636-8316
  • Fax: 216-636-6036
Mailing address:
  • Phone: 216-636-8316
  • Fax: 216-636-6036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNBCRNA109384
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: