Provider Demographics
NPI:1457637886
Name:MCDONALD, JILL M (NP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 22581
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:610-482-4795
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:2401 E EVESHAM RD
Practice Address - Street 2:STE A
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9590
Practice Address - Country:US
Practice Address - Phone:856-424-3323
Practice Address - Fax:856-424-4994
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00349800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner