Provider Demographics
NPI:1659923563
Name:PATE, JILL ALLISON (CNP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ALLISON
Last Name:PATE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1020 DENNISON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3631
Mailing Address - Country:US
Mailing Address - Phone:614-756-6027
Mailing Address - Fax:614-452-7732
Practice Address - Street 1:500 E MAIN ST STE 220
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5369
Practice Address - Country:US
Practice Address - Phone:614-222-3369
Practice Address - Fax:614-544-9671
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH404285163WE0003X
OHAPRN.CNP.024667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency