Provider Demographics
NPI:1598808925
Name:RATANAPHRUKS, JILL KATHERINE (MSN,FNP-C)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:KATHERINE
Last Name:RATANAPHRUKS
Suffix:
Gender:F
Credentials:MSN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:100 SAS CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2414
Mailing Address - Country:US
Mailing Address - Phone:919-531-9169
Mailing Address - Fax:919-654-3800
Practice Address - Street 1:100 SAS CAMPUS DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2414
Practice Address - Country:US
Practice Address - Phone:919-531-9169
Practice Address - Fax:919-654-3800
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily