Healthcare Provider Details

I. General information

NPI: 1225479389
Provider Name (Legal Business Name): JILLIAN SUZANNE VAN ORSOUW RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2013
Last Update Date: 10/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 MEDICAL CENTER PKWY STE 300
MURFREESBORO TN
37129-3237
US

IV. Provider business mailing address

PO BOX 440100
NASHVILLE TN
37244-0100
US

V. Phone/Fax

Practice location:
  • Phone: 615-848-0488
  • Fax: 615-904-9061
Mailing address:
  • Phone: 615-329-0570
  • Fax: 718-299-6797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number643641-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF338572-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: