Provider Demographics
NPI:1740838796
Name:GEORGIO, JILLIAN E (FNP-C)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:E
Last Name:GEORGIO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:E
Other - Last Name:BORASKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 ONEIL BLVD
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-4218
Mailing Address - Country:US
Mailing Address - Phone:508-342-1101
Mailing Address - Fax:508-342-1181
Practice Address - Street 1:100 ONEIL BLVD
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-4218
Practice Address - Country:US
Practice Address - Phone:508-342-1101
Practice Address - Fax:508-342-1181
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2287374363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily