Provider Demographics
NPI:1194161414
Name:LANGLEY, JILL DEANNE (CPNP-PC)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:DEANNE
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 SKYLAND DR
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-8002
Mailing Address - Country:US
Mailing Address - Phone:828-339-2273
Mailing Address - Fax:828-339-2274
Practice Address - Street 1:1188 SKYLAND DR
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-8002
Practice Address - Country:US
Practice Address - Phone:828-339-2273
Practice Address - Fax:828-339-2274
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2832082363LP0200X
NC292120363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics