Provider Demographics
NPI:1093529125
Name:BROOKSHIRE, JILLIAN
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:
Last Name:BROOKSHIRE
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 1:6827 LOCUSTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-2724
Mailing Address - Country:US
Mailing Address - Phone:937-689-6568
Mailing Address - Fax:
Practice Address - Street 1:6827 LOCUSTVIEW DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-2724
Practice Address - Country:US
Practice Address - Phone:937-689-6568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula