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General NPI Number Information
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NPI Number | 1427337666
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Entity Type | Individual
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Provider Name | JILLIAN KATHLEEN ROSS A.P.R.N.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 55 WALLS DR., SUITE 405
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City | FAIRFIELD
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State | CT
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Zip | 06825-5163
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Country | US
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Telephone | 203-259-7070
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Fax | 203-254-7402
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Provider Business Mailing Address
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Address Line | 1224 MILL ST STE 224
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City | EAST BERLIN
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State | CT
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Zip | 06023-1159
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Country | US
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Telephone | 480-862-1700
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Fax | 480-718-7643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 004688
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License Number State | CT
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