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General NPI Number Information
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NPI Number | 1952289845
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Entity Type | Individual
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Provider Name | JILLIAN BESS KANGAS
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1216 2ND ST SW
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City | ROCHESTER
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State | MN
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Zip | 55902-1906
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Country | US
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Telephone | 507-255-5123
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Fax |
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Provider Business Mailing Address
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Address Line | 4309 1ST ST NW
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City | ROCHESTER
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State | MN
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Zip | 55901-3157
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Country | US
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Telephone | 406-229-0445
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 2507078
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License Number State | MN
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