Provider Demographics
NPI:1508996547
Name:DEGRAAUW, JILL (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:DEGRAAUW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6344 HOPEWELL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-6856
Mailing Address - Country:US
Mailing Address - Phone:615-708-1956
Mailing Address - Fax:
Practice Address - Street 1:524 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-3255
Practice Address - Country:US
Practice Address - Phone:931-221-7107
Practice Address - Fax:931-221-7388
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000114976163W00000X
TNAPN0000007599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse