Organization
INCHARGECLINIC
Active
Other names
JILL MARIE MARSHALL-ALLEN, Jill Marie Marshall-Allen
Organization subpart
No
Provider details
NPI number
Authorized official
JILL MARSHALL-ALLEN APRN CWS FACCWS (MMGR)
(813) 530-9666
Entity
Organization
Contact information
Practice address
12250 BLUE PACIFIC DR, RIVERVIEW, FL 33579-1803
(813) 955-9734
(813) 366-8789
Mailing address
12250 BLUE PACIFIC DR, RIVERVIEW, FL 33579-1803
(813) 336-8789
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
—
—
174400000X
Specialist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/06/2022
Last updated
02/27/2025
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