Individual
JILLIAN CHRISTINA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91570 HIGHWAY 42, RICHTON, MS 39476-9708
(601) 791-2101
Mailing address
163 SMITHTOWN BETHEL CHURCH RD, RICHTON, MS 39476-9774
(601) 791-2101
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904679
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
09/28/2020
Last updated
08/11/2021
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