# JILLIAN ROSE MOFFETT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1649057688
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 153014 | CT | — |
| 163W00000X | Registered Nurse | 95328625 | CA | — |
| 163WP0218X | Pediatric Oncology Registered Nurse | 153014 | CT | — |
| 163WP0218X | Pediatric Oncology Registered Nurse | 95328625 | CA | — |
| 363LP0200X | Pediatric Nurse Practitioner | 95031258 | CA | Yes |
| 363LP0222X | Critical Care Pediatric Nurse Practitioner | 95031258 | CA | — |

## Other

- **Enumeration date:** 09/13/2023
- **Last updated:** 10/10/2025