Healthcare Provider Details

I. General information

NPI: 1174447700
Provider Name (Legal Business Name): JILL BOBB RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 MYSTIC LN
TROY OH
45373-2254
US

IV. Provider business mailing address

4777 W VERSAILLES RD
PIQUA OH
45356-9308
US

V. Phone/Fax

Practice location:
  • Phone: 937-332-6740
  • Fax:
Mailing address:
  • Phone: 937-332-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.246218
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: