MEDICARE: JILL TREADWELL DENMAN NP

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	363L00000X	Nurse Practitioner	APRN-NP160665	GA

General Provider Information

NPI Number	:	1699631523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL TREADWELL DENMAN NP

Provider Business Mailing Address
First Line	:	9202 HIGHWAY 278 NE
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014-7011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9202 HIGHWAY 278 NE
Second Line	:
City	:	COVINGTON
State	:	GA
Zip	:	30014-7011
Country	:	US
Telephone Number	:	678-342-8660
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	05/22/2026

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