Provider Demographics
NPI:1982761920
Name:PAGANO, JILL J (NP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:J
Last Name:PAGANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:277 GLEN LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-6129
Mailing Address - Country:US
Mailing Address - Phone:770-582-3985
Mailing Address - Fax:770-582-4192
Practice Address - Street 1:3720 DAVINCI CT
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-7627
Practice Address - Country:US
Practice Address - Phone:770-582-3985
Practice Address - Fax:770-582-4192
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN067609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily