Provider Demographics
NPI:1447056379
Name:ZERKLE, JILLIAN KAWANA (MA, CPS)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:KAWANA
Last Name:ZERKLE
Suffix:
Gender:
Credentials:MA, CPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COTTONTAIL LN UNIT B
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-8339
Mailing Address - Country:US
Mailing Address - Phone:307-254-0834
Mailing Address - Fax:307-395-7511
Practice Address - Street 1:1002 RUMSEY AVE STE A
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-3533
Practice Address - Country:US
Practice Address - Phone:307-395-7510
Practice Address - Fax:307-395-7511
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist