Provider Demographics
NPI:1376064477
Name:HARPER, JILL MARIE (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:MARIE
Last Name:HARPER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1335 UNIVERSITY ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2521
Mailing Address - Country:US
Mailing Address - Phone:509-876-7819
Mailing Address - Fax:
Practice Address - Street 1:110 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-1015
Practice Address - Country:US
Practice Address - Phone:509-876-7819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60677443363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health