Provider Demographics
NPI:1780356980
Name:APODACA, JILL H (FNP-C)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:H
Last Name:APODACA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 N MOPAC EXPY STE 150
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5459
Mailing Address - Country:US
Mailing Address - Phone:512-346-7936
Mailing Address - Fax:512-338-4450
Practice Address - Street 1:10801 N MOPAC EXPY STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5459
Practice Address - Country:US
Practice Address - Phone:512-346-7936
Practice Address - Fax:512-338-4450
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty