Provider Demographics
NPI:1922350818
Name:SPILLER, JENNIFER CHRISTINE (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CHRISTINE
Last Name:SPILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E UNIVERSITY AVE
Mailing Address - Street 2:PROTHRO SUITE 200
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6100
Mailing Address - Country:US
Mailing Address - Phone:512-863-1252
Mailing Address - Fax:512-863-1310
Practice Address - Street 1:1001 E UNIVERSITY AVE
Practice Address - Street 2:PROTHRO SUITE 200
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6100
Practice Address - Country:US
Practice Address - Phone:512-863-1252
Practice Address - Fax:512-863-1310
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX755952163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse