Individual
DEBRA J THILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1900 CENTRA CARE CIR #1300, CENTRA CARE CLINIC WOMEN'S & CHILDREN'S, ST CLOUD, MN 56303-5000
(320) 654-3610
(320) 654-3657
Mailing address
1900 CENTRA CARE CIR #1300, CENTRA CARE CLINIC WOMEN'S & CHILDREN'S, ST CLOUD, MN 56303-5000
(320) 654-3610
(320) 654-3657
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
R-095701-4
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
R095701-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06-28-04
CHAMPUS
—
01
—
1025652
PREFERRED ONE
—
01
—
1202912
MEDICA HEALTH PLANS
—
01
—
136613100
MEDICAL ASSISTANCE
—
01
—
151365
U-CARE
—
01
—
2172435
ARAZ GROUP AMERICAS PPO
—
01
—
267L3BE
BLUE CROSS BLUE SHIELD
—
01
—
6-28-04
ONEHEALTH PLAN/GREAT WEST
—
01
—
7-22-04
MMSI
—
01
—
HP31039
HEALTH PARTNERS
—
Enumeration date
10/28/2005
Last updated
12/08/2011
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