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General NPI Number Information
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NPI Number | 1174773014
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Entity Type | Individual
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Provider Name | JILDA MARIE STANDISH RRT
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Gender | Female
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 105 RINGBILL CT
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City | GEORGETOWN
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State | KY
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Zip | 40324
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Country | US
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Telephone | 502-863-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 105 RINGBILL CT
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City | GEORGETOWN
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State | KY
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Zip | 40324-9292
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Country | US
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Telephone | 502-863-5566
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2279C0205X
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Taxonomy Name | Critical Care Registered Respiratory Therapist
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License Number | 5256
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License Number State | KY
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