Jill Marie Abernathy-Wilke, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Chandler, AZ
NPI 1114624871 · NPPES record last updated Feb 13, 2023
Key facts
- NPI
- 1114624871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 247876 (AZ)
- Practice address
- 2460 W Ray Rd Ste 1
Chandler, AZ 85224-3556 - Phone
- (480) 613-9599
- NPI assigned
- Feb 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 247876 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paradigm Psychiatry PLLC | Current |
Accepting new patients |
Locations
2460 W Ray Rd
Ste 1
Chandler, AZ 85224
Phone (480) 613-9599
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 247876 | AZ | Yes |
Addresses
Primary practice location
2460 W Ray Rd Ste 1
Chandler, AZ 85224-3556
Mailing address
7362 E Rovey Ave
Scottsdale, AZ 85250-5530
Phone (228) 342-4059
Other providers in Chandler, AZ
- Rasheedat Abdul-Azeez
- Kareem Abdullah
- Amanuel Abebaw
- Vincent Abella
- Amanda Cathleen Aberer
- Kayla Abernathy
- Cornelius A Abimbola
- Modupeola Oladunni Abiodun
- Rafael Munar Ablao III
- Meredith L Abney
All providers in Chandler, AZ · Psychiatric/Mental Health Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.