Provider Demographics
NPI:1730437054
Name:PICONE, JILL MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:PICONE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 FAIRFAX PARK
Mailing Address - Street 2:SUITE C
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2836
Mailing Address - Country:US
Mailing Address - Phone:205-752-7337
Mailing Address - Fax:205-752-8013
Practice Address - Street 1:1060 FAIRFAX PARK
Practice Address - Street 2:SUITE C
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2836
Practice Address - Country:US
Practice Address - Phone:205-752-7337
Practice Address - Fax:205-752-8013
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-071583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily