Individual
JILLIAN RAE KOTERBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
713 HOLLYWOOD DR, OWOSSO, MI 48867-1109
(989) 205-7086
Mailing address
713 HOLLYWOOD DR, OWOSSO, MI 48867-1109
(989) 205-7086
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704279051
MI
363LF0000X
Family Nurse Practitioner
Primary
4704279051
MI
Other
Enumeration date
01/19/2022
Last updated
02/02/2023
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