Individual
JILL T STANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1520 NORTHWAY COURT, CENTRACARE CLINIC HEARTLAND, ST CLOUD, MN 56303
(320) 251-1775
(320) 240-3131
Mailing address
1520 NORTHWAY COURT, CENTRACARE CLINIC HEARTLAND, ST CLOUD, MN 56303
(320) 251-1775
(320) 240-3131
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R1237351
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002219500
MEDICAL ASSISTANCE
—
01
—
0110555
MEDICA HEALTH PLANS
—
01
—
1014181
PREFERRED ONE
—
01
—
122925
U CARE
—
01
—
86D79ST
BLUE CROSS BLUE SHIELD
—
01
—
HP23116
HEALTH PARTNERS
—
01
—
R1237351
MN LICENSE NUMBER
—
Enumeration date
10/31/2005
Last updated
03/07/2023
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