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General NPI Number Information
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NPI Number | 1396202198
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Entity Type | Individual
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Provider Name | JILL JOAN ALLEN APRN
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Gender | Female
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 1102 SAINT MARYS RD
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City | JUNCTION CITY
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State | KS
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Zip | 66441-4196
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Country | US
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Telephone | 784-238-4131
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 BROOKE BND
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City | JUNCTION CITY
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State | KS
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Zip | 66441-1410
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Country | US
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Telephone | 847-738-7050
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 53-78584-031
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License Number State | KS
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