Provider Demographics
NPI:1801825385
Name:WHITFIELD, JILL FUTCH (CNM)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:FUTCH
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:FUTCH
Other - Last Name:WHITFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:2 MUSGROVE LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-1715
Mailing Address - Country:US
Mailing Address - Phone:912-598-1713
Mailing Address - Fax:912-226-3268
Practice Address - Street 1:1692 CHATHAM PKWY
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1350
Practice Address - Country:US
Practice Address - Phone:912-629-6262
Practice Address - Fax:912-226-3268
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN051676367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA217083747BMedicaid