Individual
JEANNETTE RENEE LILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
175 S UNION BLVD STE 300, COLORADO SPRINGS, CO 80910-3126
(719) 365-7630
(719) 365-7631
Mailing address
335 DISCOVERY CT, COLORADO SPRINGS, CO 80919-1213
(719) 231-4579
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1617166
CO
363LF0000X
Family Nurse Practitioner
Primary
0992352
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0992352
APN
CO
01
—
1617166
REGISTERED NURSE LICENSE
CO
01
—
F0316328
AMERICAN ACADEMY OF NURSE PRACTITIONERS
CO
Enumeration date
03/29/2016
Last updated
03/06/2020
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