Individual
MRS. JILLIAN RNEA GERVAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-PC
Contact information
Practice address
760 W FRANKLIN ST, JACKSON, MI 49201-2048
(517) 780-9260
Mailing address
760 W FRANKLIN ST, JACKSON, MI 49201-2048
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704276379
MI
363LP0200X
Pediatric Nurse Practitioner
Primary
4704276379
MI
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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