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NPI Code Detail

MEDICARE: JEFFREY DUANE DILLER ACNP-BC

MEDICARE: JEFFREY DUANE DILLER ACNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerAPRN-NP163507GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245473289
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY DUANE DILLER ACNP-BC
Provider Business Mailing Address
First Line : PO BOX 3726
Second Line :
City : AUGUSTA
State : GA
Zip : 30914-3726
Country : US
Telephone Number : 706-863-9595
Fax Number : 706-868-8375
Provider Business Practice Location Address
First Line : 3950 AUSTELL RD
Second Line :
City : AUSTELL
State : GA
Zip : 30106-1121
Country : US
Telephone Number : 706-863-9595
Fax Number : 706-868-8375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2009
Last Update Date : 12/08/2025

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