Healthcare Provider Details

I. General information

NPI: 1558695254
Provider Name (Legal Business Name): JILLIAN LYNN GARRICK APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 OLENTANGY RIVER RD
COLUMBUS OH
43212-3117
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4040
  • Fax: 614-293-3465
Mailing address:
  • Phone: 614-293-4040
  • Fax: 614-293-3277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN.CNP.10977
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: