Healthcare Provider Details

I. General information

NPI: 1619082575
Provider Name (Legal Business Name): JILL C BARBOUR WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 04/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 ASHVILLE AVE
CARY NC
27518-6679
US

IV. Provider business mailing address

216 ASHVILLE AVE STE 20
CARY NC
27518-6679
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-7070
  • Fax:
Mailing address:
  • Phone: 919-781-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number940022
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: