Healthcare Provider Details

I. General information

NPI: 1346201449
Provider Name (Legal Business Name): JILL MICHELLE MCKEAND OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL HULSART OTR

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N CHURCH ST
MONROE NC
28112-4804
US

IV. Provider business mailing address

3512 RINGTAIL DR
WAXHAW NC
28173-7269
US

V. Phone/Fax

Practice location:
  • Phone: 704-296-9898
  • Fax: 704-282-2171
Mailing address:
  • Phone: 704-989-6141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5788
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: