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Individual
JILLIAN CONDON
Active
Individual
JILLIAN CONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN10004180
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
21854
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71007319A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN10001461
MA
Other
Enumeration date
09/29/2016
Last updated
05/12/2025
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