Provider Demographics
NPI:1083409684
Name:ELIAN, JILL MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MARIE
Last Name:ELIAN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6185 SCOTTHILLE DR SE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-7849
Mailing Address - Country:US
Mailing Address - Phone:616-889-5547
Mailing Address - Fax:
Practice Address - Street 1:3101 PRAIRIE ST SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2047
Practice Address - Country:US
Practice Address - Phone:616-889-5547
Practice Address - Fax:616-889-5547
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704232591163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty