Provider Demographics
NPI:1033589312
Name:STEWART, JILLIAN (MSN, NP-C)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1625 N GEORGE MASON DR STE 288
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3683
Mailing Address - Country:US
Mailing Address - Phone:703-558-6491
Mailing Address - Fax:703-524-4365
Practice Address - Street 1:1625 N GEORGE MASON DR STE 288
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3683
Practice Address - Country:US
Practice Address - Phone:703-558-6491
Practice Address - Fax:703-524-4365
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001214992163WG0000X
VA0024172977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice