Individual
MRS. JILL MARIE NORTHOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
131 PEBBLEBROOKE RUN, CANTON, GA 30115-5521
(770) 573-3290
Mailing address
131 PEBBLEBROOKE RUN, CANTON, GA 30115-5521
(770) 573-3290
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN107851
GA
Other
Enumeration date
04/07/2011
Last updated
04/07/2011
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