Provider Demographics
NPI:1700494895
Name:FERRARI, JILLIAN (APRN - FNP)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:FERRARI
Suffix:
Gender:F
Credentials:APRN - FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-2007
Mailing Address - Country:US
Mailing Address - Phone:731-733-9044
Mailing Address - Fax:
Practice Address - Street 1:364 TENNESSEE AVE S
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-2524
Practice Address - Country:US
Practice Address - Phone:731-847-6396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN215354163W00000X
NC5013322363L00000X
TN28581363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner