Healthcare Provider Details

I. General information

NPI: 1205877560
Provider Name (Legal Business Name): JILL MARIE MARSHALL-ALLEN APRN CWS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JILL MARIE ALLEN APRN CARN-AP CWS

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11806 BRUCE B DOWNS BLVD # 1272
TAMPA FL
33612-5542
US

IV. Provider business mailing address

11806 BRUCE B DOWNS BLVD # 1272
TAMPA FL
33612-5542
US

V. Phone/Fax

Practice location:
  • Phone: 813-530-9666
  • Fax: 813-729-8645
Mailing address:
  • Phone: 813-548-6773
  • Fax: 813-730-5230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN1692262
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN1692262
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number1692262
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberAPRN1692261
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: