Wall, Jill Suzanne

Wall, Jill Suzanne is an individual health care provider with primary practice located at 742 Middlecreek Rd , Sevierville TN 37862-5047. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wall, Jill Suzanne can be contacted via phone (865) 446-8835.

Contact Information

Primary practice address
742 Middlecreek Rd Sevierville TN 37862-5047
Phone: (865) 446-8835
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1193 Tennessee

Profile Details

NPI number 1043252190
LBN Legal business name Wall, Jill Suzanne
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jan 26th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043252190 NPPES
Tennessee Other P00285556 RRGA
Tennessee Other 4095095 RRGA
Tennessee MEDICAID 3663358 RRGA

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