Individual
DR. JILL M JULSRUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
470 W 78TH ST, CHANHASSEN, MN 55317-4524
(952) 843-4300
(952) 843-4301
Mailing address
470 W 78TH ST, CHANHASSEN, MN 55317-4539
(952) 843-4300
(952) 843-4301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
30269
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
749207300
—
MN
Enumeration date
02/17/2006
Last updated
10/18/2012
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