Provider Demographics
NPI:1386988764
Name:WOOD, JILLIAN FRANCES (RN, MSN, WHNP)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:FRANCES
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN, MSN, WHNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4741 DUPONT AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-5323
Mailing Address - Country:US
Mailing Address - Phone:612-599-0054
Mailing Address - Fax:
Practice Address - Street 1:968 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3014
Practice Address - Country:US
Practice Address - Phone:651-895-2520
Practice Address - Fax:651-330-3768
Is Sole Proprietor?:No
Enumeration Date:2012-11-25
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR173616-6363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health