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General NPI Number Information
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NPI Number | 1609743855
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Entity Type | Individual
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Provider Name | JILLIAN UTTARD CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 1715 SUMNEYTOWN PIKE
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City | LANSDALE
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State | PA
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Zip | 19446-4833
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Country | US
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Telephone | 215-453-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 1593 STATE RD
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City | COOPERSBURG
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State | PA
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Zip | 18036-9016
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Country | US
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Telephone | 484-553-0656
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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 | SP033734
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License Number State | PA
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