MEDICARE: JILL MARIE STOKS PHMNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	12696	MN
2	163W00000X	Registered Nurse	2321062	MN

General Provider Information

NPI Number	:	1750993317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL MARIE STOKS PHMNP

Provider Business Mailing Address
First Line	:	1212 E COLLEGE DR
Second Line	:
City	:	MARSHALL
State	:	MN
Zip	:	56258-2713
Country	:	US
Telephone Number	:	507-532-3236
Fax Number	:

Provider Business Practice Location Address
First Line	:	13526 CAMP AVE
Second Line	:
City	:	WALNUT GROVE
State	:	MN
Zip	:	56180-5343
Country	:	US
Telephone Number	:	507-626-5638
Fax Number	:

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

Provider Enumeration Date	:	08/17/2020
Last Update Date	:	04/01/2025

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