Healthcare Provider Details

I. General information

NPI: 1285440388
Provider Name (Legal Business Name): JILL ASHLEY ZUBER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 N 7TH ST
WEST MONROE LA
71291-4409
US

IV. Provider business mailing address

3105 N 8TH ST
WEST MONROE LA
71291-5009
US

V. Phone/Fax

Practice location:
  • Phone: 318-644-2573
  • Fax:
Mailing address:
  • Phone: 318-614-1273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number237015
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number237015
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: