JILLIAN HERNANDEZ SPRAGUE (NPI# 1770099319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770099319 |
| Entity Type | Individual |
| Full Name | JILLIAN HERNANDEZ SPRAGUE |
| Credential | CPNP |
| Practice Address |
101 E Matthews St Ste 800 Matthews NC 28105-5374 |
| Mailing Address |
1524 Scott Ave Unit 439 Charlotte NC 28203-1518 |
| Practice Telephone | 7043215700 |
| Mailing Telephone | 9196347096 |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2019-04-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
5011666 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 345 Main St Ste 9, Harleysville, PA 194382420 | 2152563080 |
| Street Address |
101 E MATTHEWS ST STE 800 |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-5374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594732 | Megan Hoekstra | Nurse Practitioner | 8358 Six Forks Rd Ste 204, Raleigh, NC 27615-5093 | 2020-10-04 |
| 1639713118 | Holly Hattler Barber | Nurse Practitioner | Unc Dept of Pediatrics 030 Macnider Hall Cb 7231, Chapel Hill, NC 27599-0001 | 2019-10-29 |
| 1437709565 | Molly Benson Miller | Nurse Practitioner | 101 Manning Dr Cb 7236, Chapel Hill, NC 27599-7236 | 2019-09-20 |
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1548814072 | Ashley Goodwin Friddle | Nurse Practitioner | 802 Green Valley Rd Ste 210, Greensboro, NC 27408-7099 | 2019-08-01 |
| 1740743129 | Jennifer W Farrow | Nurse Practitioner | 940 Se Cary Pkwy Ste 200, Cary, NC 27518-7417 | 2019-04-11 |
| 1538641147 | Taylor Rippy | Nurse Practitioner | 2304 Delaney Ave, Wilmington, NC 28403-6013 | 2018-08-30 |
| 1427544931 | Sheila L Mason | Nurse Practitioner | Wfbmc 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2018-07-09 |
| 1427587625 | Amanda Register | Nurse Practitioner | 110 E Park Dr, Beulaville, NC 28518-6916 | 2017-06-09 |
| 1225562812 | Kathryn Beaulieu Fournier | Nurse Practitioner | 16747 Us Highway 17 N Ste 114, Hampstead, NC 28443-3086 | 2017-04-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.