Provider Demographics
NPI:1891701942
Name:YORK, JILL WITHEROW (RN,CFNP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:WITHEROW
Last Name:YORK
Suffix:
Gender:F
Credentials:RN,CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:VA
Mailing Address - Zip Code:22727-3093
Mailing Address - Country:US
Mailing Address - Phone:540-948-6743
Mailing Address - Fax:540-948-4527
Practice Address - Street 1:1480 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:VA
Practice Address - Zip Code:22727-3093
Practice Address - Country:US
Practice Address - Phone:540-948-6743
Practice Address - Fax:540-948-4527
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024059556363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily