Provider Demographics
NPI:1952854309
Name:PRATHER, JILL (CRNA)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:PRATHER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:MCCURDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 W COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3300
Mailing Address - Country:US
Mailing Address - Phone:954-703-2931
Mailing Address - Fax:954-585-9207
Practice Address - Street 1:3601 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3300
Practice Address - Country:US
Practice Address - Phone:954-703-2931
Practice Address - Fax:954-585-9207
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL109384367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9219028OtherFLORIDA BOARD OF NURSING