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General NPI Number Information
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NPI Number | 1801211586
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Entity Type | Individual
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Provider Name | JILLYNE BOBROWSKY
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Gender | Female
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 8042 VICTORIA DRIVE
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City | VICTORIA
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State | MN
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Zip | 55386
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Country | US
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Telephone | 952-905-1982
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Fax |
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Provider Business Mailing Address
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Address Line | 16204 HIGHWAY 7
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City | MINNETONKA
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State | MN
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Zip | 55345-3405
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Country | US
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Telephone | 952-934-2555
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Fax | 952-934-3910
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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