Most Relevant Information
Provider Data
| NPI Number: | 1003435843 |
| Provider Name: | JILLY JOHN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | AP145105 |
Most Important Dates
| Enumeration Date: | 04/12/2020 |
| Last Updated: | 09/15/2021 |
Provider Practice Location
6363 N STATE HIGHWAY 161 STE 100
IRVING
TX
750382239
Practice Location Phone/Fax
| Phone: | 4692003272 |
| Fax: |
Provider Mailing Location
3524 TEXAS STAR DR
EULESS
TX
760401106
Provider Mailing Phone/Fax
| Phone: | 6823012737 |
| Fax: |