JILLIAN N PETKUS (NPI# 1174879951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174879951 |
| Entity Type | Individual |
| Full Name | JILLIAN N PETKUS |
| Credential | FNP-BC |
| Practice Address |
72 S Washington St Oxford MI 48371-6421 |
| Mailing Address |
215 E Auburn Rd Rochester Hills MI 48307-5260 |
| Practice Telephone | 2482368333 |
| Practice Fax Number | 2482368666 |
| Mailing Telephone | 2488532009 |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2014-08-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704266490 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1700036936 | 05 |
| Street Address |
72 S WASHINGTON ST |
| City | OXFORD |
| State | MI |
| Zip Code | 48371-6421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386642056 | Sheryl A Wissman | Internal Medicine | 72 S Washington St, Suite 204, Oxford, MI 48371-6421 | 2005-07-07 |
| 1679926513 | Summit Physical Therapy, Pllc | Physical Therapist | 72 S Washington St, Suite 106, Oxford, MI 48371-6421 | 2016-07-15 |
| 1497153159 | Laura Holt | Nurse Practitioner | 72 S Washington St, Suite 202, Oxford, MI 48371-6421 | 2014-12-11 |
| 1013213958 | Kenneth Michael Walter | Nurse Practitioner | 72 S Washington St, Suite 102, Oxford, MI 48371-6421 | 2011-02-09 |
| 1316265531 | Oxford Urgent Care, LLC | Emergency Medicine | 72 S Washington St, Suite 102, Oxford, MI 48371-6421 | 2010-05-12 |
| 1700036936 | Oxford Urgent Care P L C | Clinic/Center | 72 S Washington St, Suite 102, Oxford, MI 48371-6421 | 2008-09-24 |
| 1801063201 | Essential Health Chiropractic,p.c. | Chiropractor | 72 S Washington St, Suite 202, Oxford, MI 48371-4973 | 2008-05-14 |
| 1487828422 | Lawrence Michael Oshier | Psychologist | 72 S Washington St, Suite 206, Oxford, MI 48371-4973 | 2008-04-22 |
| 1285808535 | Sarah Elizabeth Giroux | Physical Therapist | 72 S Washington St, Suite 106, Oxford, MI 48371-6421 | 2008-04-17 |
| 1386769180 | Lakeside Medical Group, PC | Family Medicine | 72 S Washington St, Suite 202, Oxford, MI 48371-4973 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164915005 | Robyn Marie Ankawi | Counselor | 930 E Drahner Rd, Oxford, MI 48371 | 2018-06-13 |
| 1225557184 | Laurie Bueche | Social Worker | 1450 S Lapeer Road, Oxford, MI 48371 | 2017-09-12 |
| 1417480708 | Adam Renard Burton | Student in an Organized Health Care Education/Training Program | 801 Vivian Ln, Oxford, MI 48371 | 2017-04-04 |
| 1104378926 | Kayla Lynn Thrushman | Counselor | 2b. S. Washington Ave., Oxford, MI 48371 | 2016-10-27 |
| 1588092191 | J&j Medical, Inc. | Durable Medical Equipment & Medical Supplies | 141 Cheltenham Ln, Oxford, MI 48371 | 2013-10-16 |
| 1801232368 | Angela Mary Ramsey | Social Worker | 1450 N Lapeer Rd, Oxford, MI 48371 | 2013-05-10 |
| 1598040271 | Walgreen Co | Pharmacy | 7110 Dixie Hwy., Clarkston, MI 48371 | 2011-10-13 |
| 1417108945 | Best Value Pharmacy LLC | Pharmacy | 72 S Oxford, Suite 207, Oxford, MI 48371 | 2008-10-02 |
| 1497953533 | Rachel Maryann Klamo | Family Medicine | 72 South Washington St., Suite 204, Oxford, MI 48371 | 2007-07-10 |
| 1528185378 | Gregory Michael Garvin | Preventive Medicine | 760 Woodleigh Way, Oxford, MI 48371 | 2007-03-26 |
| Find all providers in zip 48371 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124632716 | Oxford Specialty Clinic | Nurse Practitioner | 1205 Office Park Dr, Oxford, MS 38655-3545 | 2020-09-01 |
| 1659994044 | Christopher Killis Scruggs | Nurse Practitioner | 132 Yocona Ridge Rd, Oxford, MS 38655-6904 | 2020-05-20 |
| 1164062105 | Sarah Marie Fitzpatrick | Nurse Practitioner | 1070 Brookside Ct, Oxford, MI 48371-6055 | 2020-01-07 |
| 1710522198 | Laura Nicole Kelleway | Nurse Practitioner | 23 County Road 205, Oxford, MS 38655-9794 | 2019-11-09 |
| 1780225441 | Lija Turaida Moncrieff-austin | Nurse Practitioner | 500 E Peninsula Ct, Oxford, MI 48371-3669 | 2019-10-03 |
| 1861044026 | Mirian Thiruchendru | Nurse Practitioner | 72 S Washington St Ste 102, Oxford, MI 48371-6421 | 2019-07-09 |
| 1649752312 | Aubrey Michelle Mcintosh | Nurse Practitioner | 904 Crestmoor Dr, Oxford, MI 48371-4870 | 2018-08-30 |
| 1760969208 | Tina Gail Bryan | Nurse Practitioner | 7 County Road 469, Oxford, MS 38655-8279 | 2018-07-27 |
| 1699277509 | Lindsey Wall Hemphill | Nurse Practitioner | 45 County Road 277, Oxford, MS 38655-8739 | 2018-03-06 |
| 1023527017 | Katherine Waters | Nurse Practitioner | 2301 S Lamar Blvd # 140, Oxford, MS 38655-5373 | 2017-09-22 |
| Find all providers in OXFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.