Provider Demographics
NPI:1871866376
Name:WELKER, JILL ANNA (PA)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ANNA
Last Name:WELKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 W NORTHFIELD BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0531
Mailing Address - Country:US
Mailing Address - Phone:615-848-2900
Mailing Address - Fax:615-848-2956
Practice Address - Street 1:237 W NORTHFIELD BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0531
Practice Address - Country:US
Practice Address - Phone:615-848-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-472363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant