Individual
MRS. JILL LYNN FEDERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
IHA BREAST SURGERY, 5320 ELLIOTT DRIVE SUITE 203, YPSILANTI, MI 48197
(734) 712-1700
(734) 887-8938
Mailing address
24 FRANK LLOYD WRIGHT DRIVE, SUITE J2000, ANN ARBOR, MI 48105
(734) 747-6766
(734) 222-3100
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
4704230297
MI
363LF0000X
Family Nurse Practitioner
3007458
OH
363LF0000X
Family Nurse Practitioner
Primary
4704230297
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JF230297
RN LIC.
MI
Enumeration date
03/16/2010
Last updated
08/09/2023
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