Healthcare Provider Details

I. General information

NPI: 1336658772
Provider Name (Legal Business Name): JADE F. HILLERY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 E BELLEFONTE AVE APT 302
ALEXANDRIA VA
22301-1441
US

IV. Provider business mailing address

27 E BELLEFONTE AVE APT 302
ALEXANDRIA VA
22301-1441
US

V. Phone/Fax

Practice location:
  • Phone: 571-268-7136
  • Fax:
Mailing address:
  • Phone: 571-268-7136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: