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Individual
JILL T KOOYOOMJIAN
Active
Individual
JILL T KOOYOOMJIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
274888
MA
363L00000X
Nurse Practitioner
RN274888
MA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
274888
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110080842A
—
MA
Enumeration date
10/17/2008
Last updated
06/10/2020
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