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General NPI Number Information
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NPI Number | 1720873714
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Entity Type | Individual
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Provider Name | JILLEIGHAN MARIE BOIVIN RN
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Gender | Female
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 602 INDIANA AVE
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City | LUBBOCK
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State | TX
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Zip | 79415-3364
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Country | US
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Telephone | 806-775-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 CHICAGO AVE APT 8301
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City | LUBBOCK
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State | TX
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Zip | 79414-6029
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Country | US
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Telephone | 817-903-1822
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 1133824
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License Number State | TX
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