Provider Demographics
NPI:1245284249
Name:CEASE, JILL SUZANNE (CNP)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:SUZANNE
Last Name:CEASE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:20399 TURTLE RIVER LAKE RD NE
Mailing Address - Street 2:
Mailing Address - City:HINES
Mailing Address - State:MN
Mailing Address - Zip Code:56647
Mailing Address - Country:US
Mailing Address - Phone:218-368-2093
Mailing Address - Fax:218-835-3301
Practice Address - Street 1:20399 TURTLE RIVER LAKE RD NE
Practice Address - Street 2:
Practice Address - City:HINES
Practice Address - State:MN
Practice Address - Zip Code:56647
Practice Address - Country:US
Practice Address - Phone:218-368-2093
Practice Address - Fax:218-835-3301
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK813363LF0000X
MNCNP2688363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN102712300Medicaid
MN1032258OtherMN PREFERRED ONE
MN01-10162OtherMEDICA
MNHP39261OtherHEALTHPARTNERS
MN310T4CEOtherBLUECROSS BLUESHIELD
500029685OtherRAILROAD MEDICARE