Healthcare Provider Details

I. General information

NPI: 1801825385
Provider Name (Legal Business Name): JILL FUTCH WHITFIELD CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL FUTCH WHITFIELD CNM

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1692 CHATHAM PKWY
SAVANNAH GA
31405-1350
US

IV. Provider business mailing address

2 MUSGROVE LN
SAVANNAH GA
31411-1715
US

V. Phone/Fax

Practice location:
  • Phone: 912-629-6262
  • Fax: 912-226-3268
Mailing address:
  • Phone: 912-598-1713
  • Fax: 912-226-3268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN051676
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: