Healthcare Provider Details

I. General information

NPI: 1518247436
Provider Name (Legal Business Name): JILLIAN PETER-TRUESDELL N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILLIAN PETER

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 HATCHES POND LN STE 101
MORRISVILLE NC
27560-6294
US

IV. Provider business mailing address

1125 HATCHES POND LN STE 101
MORRISVILLE NC
27560-6294
US

V. Phone/Fax

Practice location:
  • Phone: 919-467-7425
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number339838
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: