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Individual

JILL T. PROCTOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
781 WEATHERLY DR APT C, CLARKSVILLE, TN 37043-8954
(931) 444-5040
Mailing address
820 SPRINGER DR, LOMBARD, IL 60148-6413
(815) 744-8554

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
7799
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7799
APN LICENSE
TN
Enumeration date
10/18/2006
Last updated
04/03/2023
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