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General NPI Number Information
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NPI Number | 1528712841
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Entity Type | Individual
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Provider Name | JILL T MCDONALD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2022
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Last Update Date | 02/06/2022
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Provider Practice Location Address
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Address Line | 1222 TROTWOOD AVE STE 603
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City | COLUMBIA
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State | TN
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Zip | 38401-6410
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Country | US
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Telephone | 931-490-1295
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Fax |
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Provider Business Mailing Address
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Address Line | 42 HAWTHORNE DR
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City | LAWRENCEBURG
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State | TN
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Zip | 38464-7039
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Country | US
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Telephone | 931-629-9968
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Fax |
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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 | 31112
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 31112
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License Number State | TN
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