Healthcare Provider Details

I. General information

NPI: 1336841881
Provider Name (Legal Business Name): JILLIAN JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JILLIAN LYNNE HOLCOMBE ENGLAND FNP

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 TOWN CENTER DR STE 6
ANNISTON AL
36205-4102
US

IV. Provider business mailing address

1400 AFFLINK PL STE 101
TUSCALOOSA AL
35406-2452
US

V. Phone/Fax

Practice location:
  • Phone: 256-847-3369
  • Fax:
Mailing address:
  • Phone: 205-366-9740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1-101040
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-101040
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: