Provider Demographics
NPI:1619752508
Name:HERRON, JILLIAN RAE (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:RAE
Last Name:HERRON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 CLAYTON LN STE 102W
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2433
Mailing Address - Country:US
Mailing Address - Phone:512-872-6868
Mailing Address - Fax:
Practice Address - Street 1:1106 CLAYTON LN STE 102W
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2433
Practice Address - Country:US
Practice Address - Phone:512-872-6868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2025-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily