Individual
JILL EVELYN JERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
719 GREEN VALLEY ROAD, SUITE 101, GREENSBORO, NC 27408-7022
(336) 370-0277
(336) 333-9757
Mailing address
1200 N ELM ST, INS CREDENTIALING-REVOLUTION MILL 5, GREENSBORO, NC 27401-1004
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2016-00338
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952388019
—
NC
01
—
19JA7
BCBSNC
NC
Enumeration date
12/29/2005
Last updated
08/18/2021
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