Provider Demographics
NPI:1780356980
Name:APODACA, JILL H (FNP-C)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:H
Last Name:APODACA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 BULBINE DRIVE
Mailing Address - Street 2:BUILDING 2, STE 200
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641
Mailing Address - Country:US
Mailing Address - Phone:512-410-6072
Mailing Address - Fax:512-402-5416
Practice Address - Street 1:149 BULBINE DRIVE
Practice Address - Street 2:BUILDING 2, STE 200
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641
Practice Address - Country:US
Practice Address - Phone:512-410-6072
Practice Address - Fax:512-402-5416
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty