Provider Demographics
NPI:1942860432
Name:CHAMBERLAND, JILLIAN LEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:LEIGH
Last Name:CHAMBERLAND
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 1:100 CUMMINGS CTR STE 136P
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6127
Mailing Address - Country:US
Mailing Address - Phone:978-232-5400
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 136P
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6127
Practice Address - Country:US
Practice Address - Phone:978-232-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant