Individual
JILL MICHALAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5871 MONCLOVA RD, MAUMEE, OH 43537-1839
(419) 897-8376
(419) 887-8789
Mailing address
5871 MONCLOVA RD, MAUMEE, OH 43537-1839
(198) 978-3764
(419) 887-8789
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
RN249642
OH
363L00000X
Nurse Practitioner
Primary
APRN.CNP.15618
OH
363LF0000X
Family Nurse Practitioner
COA.15618-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0118302
—
OH
Enumeration date
09/18/2014
Last updated
11/03/2023
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