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NPI Code Detail

MEDICARE: MRS. JILLIAN RAE HERRON APRN, FNP-C

MEDICARE: MRS. JILLIAN RAE HERRON APRN, 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
1363LF0000XFamily Nurse Practitioner1130826TX

General Provider Information

NPI Number : 1619752508
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JILLIAN RAE HERRON APRN, FNP-C
Provider Business Mailing Address
First Line : 1106 CLAYTON LN STE 102W
Second Line :
City : AUSTIN
State : TX
Zip : 78723-2433
Country : US
Telephone Number : 512-872-6868
Fax Number :
Provider Business Practice Location Address
First Line : 1106 CLAYTON LN STE 102W
Second Line :
City : AUSTIN
State : TX
Zip : 78723-2433
Country : US
Telephone Number : 512-872-6868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2023
Last Update Date : 12/18/2025

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