Healthcare Provider Details

I. General information

NPI: 1043730229
Provider Name (Legal Business Name): JILLIAN PARSONS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 LAKE STREET
EPHRATA PA
17522-2415
US

IV. Provider business mailing address

500 E DECATUR ST
WEST POINT NE
68788-1566
US

V. Phone/Fax

Practice location:
  • Phone: 717-721-7718
  • Fax:
Mailing address:
  • Phone: 402-372-2404
  • Fax: 402-372-6770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT214371
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33102
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: