MEDICARE: MS. JILL ASHLEY COLTRIN ARNP, FNP-C

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
1	163W00000X	Registered Nurse	ARNP9330894	FL
2	363LF0000X	Family Nurse Practitioner	ARNP9330894	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1326498775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILL ASHLEY COLTRIN ARNP, FNP-C

Provider Business Mailing Address
First Line	:	400 S ORLANDO AVE STE 202
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-5644
Country	:	US
Telephone Number	:	407-968-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S ORLANDO AVE STE 202
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-5644
Country	:	US
Telephone Number	:	407-968-1600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	02/13/2023

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