MEDICARE: MS. JILL SUZANNE CEASE CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	813	AK
2	363LF0000X	Family Nurse Practitioner	CNP2688	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	500029685	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1032258	OTHER	MN	MN PREFERRED ONE
3	01-10162	OTHER	MN	MEDICA
4	HP39261	OTHER	MN	HEALTHPARTNERS
5	310T4CE	OTHER	MN	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1245284249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILL SUZANNE CEASE CNP

Provider Business Mailing Address
First Line	:	20399 TURTLE RIVER LAKE RD NE
Second Line	:
City	:	HINES
State	:	MN
Zip	:	56647
Country	:	US
Telephone Number	:	218-368-2093
Fax Number	:	218-835-3301

Provider Business Practice Location Address
First Line	:	20399 TURTLE RIVER LAKE RD NE
Second Line	:
City	:	HINES
State	:	MN
Zip	:	56647
Country	:	US
Telephone Number	:	218-368-2093
Fax Number	:	218-835-3301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	03/11/2019

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