Jill Darlene Pridgen in Mabank - Physician Assistant
Jill Darlene Pridgen - NPI 1104021013
Jill Darlene Pridgen is a Physician Assistant in Mabank, Texas. Jill Darlene Pridgen practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jill Darlene Pridgen is 1104021013. The last update date is 2010-10-26.
Jill Darlene Pridgen's current location address is 604 S 3rd St, Mabank, Texas. You can contact this provider via phone number 9038871073. The mailing address for Jill Darlene Pridgen is 604 S 3rd St, Mabank, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jill Darlene Pridgen |
|---|---|
| Address | 604 S 3rd St, Mabank, Texas |
| Phone Number | 9038871073 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C, M.S. |
NPI Number Detail
| NPI Number | 1104021013 |
|---|---|
| Provider Enumeration Date | 2007-06-19 |
| Last Updated Date | 2010-10-26 |
Provider Mailing Address Detail
| Address | 604 S 3rd St |
|---|---|
| City | Mabank |
| State | Texas (TX) |
| Post Code | 751472700 |
| Phone Number | 9038871073 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA 01037 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique 10-digit identifier code assigned to Jill Darlene Pridgen by the Centers for Medicare & Medicaid Services?
The Jill Darlene Pridgen has been issued the NPI (National Provider Identifier) 1104021013 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Jill Darlene Pridgen's facilities are situated?
The facilities of Jill Darlene Pridgen are physically located at the following address: 604 S 3Rd St, Mabank, TX, 751472700.
What is Jill Darlene Pridgen's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jill Darlene Pridgen's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
When did the Jill Darlene Pridgen receive its 1104021013?
The Jill Darlene Pridgen was issued its 1104021013 on 2007-06-19, which is the date when the organization was assigned this unique identifier.
When was the information regarding Jill Darlene Pridgen most recently updated?
The details pertaining to the Jill Darlene Pridgen, including its address, specialty, and other relevant information, were last refreshed on 2010-10-26.
NPI Number: 1376546309
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