Provider Demographics
NPI:1144872979
Name:MEINTS, JILL RENAE
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:RENAE
Last Name:MEINTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13632 E FG AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:MI
Mailing Address - Zip Code:49012-9723
Mailing Address - Country:US
Mailing Address - Phone:269-731-4321
Mailing Address - Fax:
Practice Address - Street 1:300 NORTH AVENUE
Practice Address - Street 2:BRONSON BATTLE CREEK HOSPITAL
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015
Practice Address - Country:US
Practice Address - Phone:269-245-6255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI52010001761225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation