Provider Demographics
NPI:1962595272
Name:FINNEGAN, JILL M (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:M
Last Name:FINNEGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:910-251-2066
Practice Address - Street 1:1202 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7307
Practice Address - Country:US
Practice Address - Phone:910-341-3336
Practice Address - Fax:910-251-2066
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101817363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00272150OtherRAILROAD MEDICARE
NC2751577DMedicare PIN
NC2751577CMedicare PIN
NC2751577EMedicare PIN
NC2751577AMedicare PIN
NCS56253Medicare UPIN
NC2751577BMedicare PIN