Healthcare Provider Details

I. General information

NPI: 1619450889
Provider Name (Legal Business Name): JILLIAN LEE MCNEIL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date: 09/27/2018
Reactivation Date: 03/21/2025

III. Provider practice location address

95 TREMONT ST STE 2
DUXBURY MA
02332-4738
US

IV. Provider business mailing address

4 HOLIDAY LN
SANDWICH MA
02563-2588
US

V. Phone/Fax

Practice location:
  • Phone: 781-803-7757
  • Fax:
Mailing address:
  • Phone: 508-564-2239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2279603
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: