Provider Demographics
NPI:1295299220
Name:HILLS, JESSICA JOHNSON (FNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:JOHNSON
Last Name:HILLS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:570 MEMORIAL CIRCLE
Mailing Address - Street 2:STE 120
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174
Mailing Address - Country:US
Mailing Address - Phone:386-310-1310
Mailing Address - Fax:386-368-7506
Practice Address - Street 1:570 MEMORIAL CIR STE 120
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5063
Practice Address - Country:US
Practice Address - Phone:386-310-1310
Practice Address - Fax:386-368-7506
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF011907777363LF0000X
FL11001564363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily