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General NPI Number Information
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NPI Number | 1700095213
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Entity Type | Individual
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Provider Name | JILL DANIELLE NERIO ATC
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 800 TUCKER DR
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City | TULSA
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State | OK
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Zip | 74104-9700
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Country | US
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Telephone | 918-631-5228
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Fax | 918-631-3057
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Provider Business Mailing Address
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Address Line | 5830 S RICHMOND AVE
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City | TULSA
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State | OK
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Zip | 74135-4224
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Country | US
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Telephone | 918-551-7043
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 329
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License Number State | OK
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