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General NPI Number Information
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NPI Number | 1417208299
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Entity Type | Individual
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Provider Name | HILLARY ANN ROSS CPNP
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Gender | Female
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Dates
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Enumeration Date | 09/20/2012
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 2450 RIVERSIDE AVE UNIVERSITY OF MINNESOTA AMPLATZ CHILDREN'S HOSPITAL
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City | MINNEAPOLIS
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State | MN
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Zip | 55454-1450
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Country | US
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Telephone | 612-626-2646
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Fax |
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Provider Business Mailing Address
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Address Line | 420 DELAWARE ST SE MMC 366 SUITE 660G CANCER CENTER RESEARCH BUILDING
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City | MINNEAPOLIS
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State | MN
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Zip | 55455-0341
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Country | US
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Telephone | 612-626-2646
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 20121837
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License Number State | MN
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