Basic Information
| Provider Information | |||||||||
| NPI: | 1962907295 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARNER | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | RN, CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 LILAC LN | ||||||||
| Address2: | |||||||||
| City: | NEWMARKET | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038571839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039699823 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11 CRUM ELBOW RD | ||||||||
| Address2: | |||||||||
| City: | HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125382852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452291020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2018 | ||||||||
| LastUpdateDate: | 03/28/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WD0400X | 742503-1 | NY | Y | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No ID Information.