Provider Demographics
NPI:1619752508
Name:HERRON, JILLIAN RAE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:RAE
Last Name:HERRON
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Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:101 W LOUIS HENNA BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-1203
Mailing Address - Country:US
Mailing Address - Phone:512-244-4272
Mailing Address - Fax:512-244-2895
Practice Address - Street 1:3500 HILLCREST DR STE 1
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3144
Practice Address - Country:US
Practice Address - Phone:254-741-6641
Practice Address - Fax:254-537-4693
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1130826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily