Provider Demographics
NPI:1710640925
Name:GORO, JILLIAN (NP)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:GORO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2570 HOLCOMB BRIDGE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5415
Mailing Address - Country:US
Mailing Address - Phone:770-650-8980
Mailing Address - Fax:770-650-5589
Practice Address - Street 1:2570 HOLCOMB BRIDGE RD STE 110
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-5415
Practice Address - Country:US
Practice Address - Phone:770-650-8980
Practice Address - Fax:770-650-5589
Is Sole Proprietor?:No
Enumeration Date:2021-10-15
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY348684363LF0000X
GARN323546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily