Healthcare Provider Details

I. General information

NPI: 1780970004
Provider Name (Legal Business Name): JILL KATHERINE STEAGALL APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL KATHERINE CLINE

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WHEELING ST
AURORA CO
80045-7211
US

IV. Provider business mailing address

1700 WHEELING ST
AURORA CO
80045-7211
US

V. Phone/Fax

Practice location:
  • Phone: 608-279-1347
  • Fax:
Mailing address:
  • Phone: 608-279-1347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4417-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: