Individual
JILLIAN FAITH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
301 GORDON GUTMANN BLVD STE 101, JEFFERSONVILLE, IN 47130-3765
(812) 282-4844
(812) 282-6248
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 559-9337
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
71013433A
IN
363LF0000X
Family Nurse Practitioner
Primary
71013433A
IN
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
71013433A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300071829
—
IN
05
—
7100890880
—
KY
01
—
IN2570114
MEDICARE
IN
Enumeration date
01/04/2023
Last updated
04/05/2024
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