MEDICARE: MS. JILLIAN KATRINA BENOIT FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP133151	TX
2	363LF0000X	Family Nurse Practitioner	40274	TN

General Provider Information

NPI Number	:	1467999367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILLIAN KATRINA BENOIT FNP-C

Provider Business Mailing Address
First Line	:	7629 TIKI DR
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-1514
Country	:	US
Telephone Number	:	281-346-0018
Fax Number	:

Provider Business Practice Location Address
First Line	:	7629 TIKI DR
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-1514
Country	:	US
Telephone Number	:	281-346-0018
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2017
Last Update Date	:	03/05/2026

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