Provider Demographics
NPI:1710311345
Name:MCGILL, JESSICA V (CRNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:V
Last Name:MCGILL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-615-2222
Mailing Address - Fax:215-875-4865
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:2ND FLOOR WEST PAVILLION
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-615-2222
Practice Address - Fax:215-875-4865
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01352200363LW0102X
PASP013118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health