Healthcare Provider Details

I. General information

NPI: 1306262191
Provider Name (Legal Business Name): JILL TUREK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 09/21/2020
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 S MARION ST
BLOOMVILLE OH
44818-9201
US

IV. Provider business mailing address

58 S MARION ST
BLOOMVILLE OH
44818-9201
US

V. Phone/Fax

Practice location:
  • Phone: 419-983-2711
  • Fax:
Mailing address:
  • Phone: 419-983-2711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: