Provider Demographics
NPI:1801096607
Name:CHISHOLM, JILL ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ELIZABETH
Last Name:CHISHOLM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:75 CLAREMONT RD STE 308
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-2271
Mailing Address - Country:US
Mailing Address - Phone:908-766-2800
Mailing Address - Fax:908-517-3887
Practice Address - Street 1:75 CLAREMONT RD STE 308
Practice Address - Street 2:
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2271
Practice Address - Country:US
Practice Address - Phone:908-766-2800
Practice Address - Fax:908-517-3887
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN11307300363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology