Provider Demographics
NPI:1487969820
Name:TITZE, JILL (NP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:TITZE
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:3500 FRANCE AVE N STE 200
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2809
Mailing Address - Country:US
Mailing Address - Phone:763-581-5678
Mailing Address - Fax:763-581-9401
Practice Address - Street 1:5200 DOUGLAS DR N
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55429-3104
Practice Address - Country:US
Practice Address - Phone:763-400-3628
Practice Address - Fax:763-342-4183
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNCNP 3022363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health