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General NPI Number Information
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NPI Number | 1356338164
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Entity Type | Individual
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Provider Name | JILL JANINE O'REAR APN
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Gender | Female
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 101 BODIN CIRCLE DAVID GRANT MEDICAL CENTER
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City | TRAVIS AFB
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State | CA
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Zip | 94535-1800
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Country | US
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Telephone | 707-423-3697
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BODIN CIRCLE DAVID GRANT MEDICAL CENTER
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City | TRAVIS AFB
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State | CA
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Zip | 94535-1800
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Country | US
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Telephone | 707-423-3697
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN00122909
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN00122909
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License Number State | WA
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