Healthcare Provider Details

I. General information

NPI: 1033438809
Provider Name (Legal Business Name): JILLIAN JOLLEY CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DOOLI JOLLEY CD(DONA), LCCE

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 12/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S WASHINGTON AVE
FREDERICKSBURG IA
50630-1036
US

IV. Provider business mailing address

12760 GILLON DR
FRISCO TX
75035-2236
US

V. Phone/Fax

Practice location:
  • Phone: 801-380-2818
  • Fax:
Mailing address:
  • Phone: 801-380-2818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: