Individual
JILL MARIE ROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
232 W 25TH ST, ERIE, PA 16544-0002
(814) 452-5000
Mailing address
232 W 25TH ST, ERIE, PA 16544-0002
(814) 452-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
382899-1
NY
163W00000X
Registered Nurse
RN278183L
PA
363LF0000X
Family Nurse Practitioner
F335103-1
NY
363LF0000X
Family Nurse Practitioner
Primary
SP009082
PA
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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