Jill Jocelyn Christie, C.F.N.P
Individual provider Active NPI Family Nurse Practitioner · Dawson, MN
NPI 1790719144 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1790719144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R 119316-5 (MN)
- Practice address
- 1272 Walnut St
Dawson, MN 56232-2333 - Phone
- (320) 769-4393
- Fax
- (320) 769-2972
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040105000324 | MN | Practitioner - Nurse Practitioner | 1052210572 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 119316-5 | MN | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R 119316-5 | MN | Yes |
Addresses
Primary practice location
1272 Walnut St
Dawson, MN 56232-2333
Mailing address
1272 Walnut St
Dawson, MN 56232-2333
Phone (320) 769-4393
Other providers in Dawson, MN
- Avera Marshall
- Lisa D Bojado
- Mary Ann Bothun
- Brown Clinic PLLP
- Utpal U Chakravorty
- Erica Clark
- Dawson Drug PLLC
- Dawson Drug PLLC
- Divine House II Inc.
- Krystle Marie Drietz
All providers in Dawson, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.