Provider Demographics
NPI:1841634227
Name:PHILBIN, JILLIAN T (MSN, APRN, NP-C)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:T
Last Name:PHILBIN
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:MS
Other - First Name:JILLIAN
Other - Middle Name:A
Other - Last Name:TANNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, NP-C
Mailing Address - Street 1:176 BRUSHY HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2520
Mailing Address - Country:US
Mailing Address - Phone:203-313-5897
Mailing Address - Fax:
Practice Address - Street 1:25 TAMARACK AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-4829
Practice Address - Country:US
Practice Address - Phone:203-797-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2274068363L00000X
CT6540363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner