Provider Demographics
NPI:1982922258
Name:KILLEEN, JESSICA GUILFOIL (WHNP-BC, ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:GUILFOIL
Last Name:KILLEEN
Suffix:
Gender:F
Credentials:WHNP-BC, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:105 COLLIER RD NW
Mailing Address - Street 2:SUITE 1080
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1710
Mailing Address - Country:US
Mailing Address - Phone:404-352-2850
Mailing Address - Fax:404-352-0947
Practice Address - Street 1:105 COLLIER RD NW
Practice Address - Street 2:SUITE 1080
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1710
Practice Address - Country:US
Practice Address - Phone:404-352-2850
Practice Address - Fax:404-352-0947
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN185537363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health