Provider Demographics
NPI:1639352198
Name:HUNCHIS, JILL MARIE (NP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:HUNCHIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:REITER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:200 FIRST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905
Mailing Address - Country:US
Mailing Address - Phone:507-284-2623
Mailing Address - Fax:
Practice Address - Street 1:200 FIRST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905
Practice Address - Country:US
Practice Address - Phone:507-284-2623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR187528-9363L00000X
TX697876363L00000X
MN0750363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN500005978Medicare PIN
MN500004784Medicare PIN