Jill Suzanne Wilson
Individual provider Active NPI In Home Supportive Care Agency · Coshocton, OH
NPI 1609594092 · NPPES record last updated Aug 22, 2022
Key facts
- NPI
- 1609594092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- License
- 1601943 (OH)
- Practice address
- 85 Pine St Apt 107
Coshocton, OH 43812-1937 - Phone
- (330) 275-0509
- NPI assigned
- Aug 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1601943 | OH | MD | In Home Supportive Care Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 1601943 | OH | Yes |
Addresses
Primary practice location
85 Pine St Apt 107
Coshocton, OH 43812-1937
Mailing address
1745 Chestnut St
Coshocton, OH 43812-1439
Phone (330) 275-0509
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1601943 | Medicaid | OH |
Other providers in Coshocton, OH
- Jamie Williams
- Janell Louise Williams
- Maliya Avyana Williams
- Christine Lynette Wilson-Arnold
- Cheyenne Jodene Wilson
- Nicole Wilson
- Thomas A Wilson
- Toni Ann Wilson
- Tracy Lee Winans
- Jennifer Haven Wohlheter
All providers in Coshocton, OH · In Home Supportive Care Agency in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.