Jeter, Jill Nicole
Jeter, Jill Nicole is an individual health care provider with primary practice located at 140 South Holly Street , Medford OR 97501. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Jeter, Jill Nicole can be contacted via phone (541) 774-8200.Contact Information
Primary practice address
140 South Holly Street
Medford OR 97501
Phone: (541) 774-8200
Fax: (541) 774-7964
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1073866240 |
|---|---|
| LBN Legal business name | Jeter, Jill Nicole |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2012 |
| Last updated | Dec 12th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073866240 | NPPES |
| Oregon | MEDICAID | 123190 |
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