Doctor Name: | JANE JONES LILLEY |
NPI Number: | 1073561676 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 5004287 |
Business Practice Address: | 702 N Main St Emporia, VA - 238471242 |
Business Phone Number: | 4346347723 |
Business Fax Number: | 4346347725 |
Mailing Address: | Po Box 70, VICTORIA |
State: | VA |
Postal Code: | 239740070 |
Phone Number: | 4346962165 |
Fax Number: | 4346961557 |
NPI Enumeration Date: | 05/05/2006 |
NPI Last Update Date: | 02/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5004287 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |