Individual
MRS. JILL ANN HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
19465 DEERFIELD AVE STE 101, LEESBURG, VA 20176-1702
(703) 726-9720
(703) 726-9721
Mailing address
19465 DEERFIELD AVE STE 101, LEESBURG, VA 20176-1702
(703) 726-9720
(703) 726-9721
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024173256
VA
363LF0000X
Family Nurse Practitioner
71002526A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200888840
—
IN
01
—
P00833898
RAILROAD MEDICARE
—
Enumeration date
10/18/2007
Last updated
03/26/2024
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