Individual
JILL PRINSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP
Contact information
Practice address
360 SHERMAN ST, SUITE 299, SAINT PAUL, MN 55102-2564
(651) 291-9000
(651) 291-8894
Mailing address
360 SHERMAN ST, SUITE 299, SAINT PAUL, MN 55102-2564
(651) 291-9000
(651) 291-8894
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP003671
ABC CERTIFICATION NUMBER
—
Enumeration date
05/10/2010
Last updated
05/10/2010
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