Provider Demographics
NPI:1356898266
Name:ABRAMS, JILL (RN)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 W GERMANTOWN PIKE
Mailing Address - Street 2:1314
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1030
Mailing Address - Country:US
Mailing Address - Phone:610-329-7252
Mailing Address - Fax:610-495-1848
Practice Address - Street 1:666 W GERMANTOWN PIKE
Practice Address - Street 2:1314
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1030
Practice Address - Country:US
Practice Address - Phone:610-329-7252
Practice Address - Fax:610-495-1848
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN278360L374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN278360LOtherMEDICARE PTAN498900