Provider Demographics
NPI:1083104608
Name:MCGEE, JILLIAN LONG (RN, MSN, WHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:LONG
Last Name:MCGEE
Suffix:
Gender:F
Credentials:RN, MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 POWDER SPRINGS RD SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5279
Mailing Address - Country:US
Mailing Address - Phone:706-831-0430
Mailing Address - Fax:
Practice Address - Street 1:1700 HOSPITAL SOUTH DR STE 504
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106
Practice Address - Country:US
Practice Address - Phone:770-819-9211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GARN216616363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program