Provider Demographics
NPI:1043020878
Name:WALROD, JILL NICOLE
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:NICOLE
Last Name:WALROD
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 1:2811 TIERRA DR APT 312
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-5021
Mailing Address - Country:US
Mailing Address - Phone:402-430-4816
Mailing Address - Fax:
Practice Address - Street 1:5600 S 48TH ST STE 118
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4110
Practice Address - Country:US
Practice Address - Phone:402-474-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant