Provider Demographics
NPI:1659923563
Name:PATE, JILL ALLISON (CNP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ALLISON
Last Name:PATE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 DENNISON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3631
Mailing Address - Country:US
Mailing Address - Phone:614-756-6027
Mailing Address - Fax:614-452-7732
Practice Address - Street 1:1020 DENNISON AVE STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3631
Practice Address - Country:US
Practice Address - Phone:614-756-6027
Practice Address - Fax:614-452-7732
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH404285163WE0003X
OHAPRN.CNP.024667363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily