Provider Demographics
NPI:1699044677
Name:SMITH, JILL PAULETTE (PA)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:PAULETTE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 W END AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1080
Mailing Address - Country:US
Mailing Address - Phone:615-866-4238
Mailing Address - Fax:615-383-7976
Practice Address - Street 1:3404 W END AVE STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1080
Practice Address - Country:US
Practice Address - Phone:615-866-4238
Practice Address - Fax:615-383-7976
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
TNPA0000003302363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical