Provider Demographics
NPI:1881563294
Name:GUNDERSON, JILLIAN ROSE (FNP)
Entity type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:ROSE
Last Name:GUNDERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11299 MESSINA WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4248
Mailing Address - Country:US
Mailing Address - Phone:775-313-8384
Mailing Address - Fax:
Practice Address - Street 1:11299 MESSINA WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4248
Practice Address - Country:US
Practice Address - Phone:775-313-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV893407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily