Healthcare Provider Details

I. General information

NPI: 1720317316
Provider Name (Legal Business Name): JILLIAN MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 POWERS BLVD
PARMA OH
44129-5437
US

IV. Provider business mailing address

27337 BEATRICE LN
OLMSTED TWP OH
44138-4243
US

V. Phone/Fax

Practice location:
  • Phone: 440-743-4020
  • Fax:
Mailing address:
  • Phone: 216-990-9688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0033137
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.354531
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: