Provider Demographics
NPI:1275368300
Name:WINES, JILL AUDREY (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:AUDREY
Last Name:WINES
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5502 92ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-4510
Mailing Address - Country:US
Mailing Address - Phone:806-781-6907
Mailing Address - Fax:
Practice Address - Street 1:5504 92ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-4510
Practice Address - Country:US
Practice Address - Phone:806-781-6907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based