| Doctor Name: | JILL MARIE ROOT |
| NPI Number: | 1134382591 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 2008004407 |
| Business Practice Address: | 402 Red River Ave N Cold Spring, MN - 563201521 |
| Business Phone Number: | 3206858641 |
| Business Fax Number: | 3206854020 |
| Mailing Address: | 402 Red River Ave N, COLD SPRING |
| State: | MN |
| Postal Code: | 563201521 |
| Phone Number: | 3206858641 |
| Fax Number: | 3206854020 |
| NPI Enumeration Date: | 07/07/2008 |
| NPI Last Update Date: | 02/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2008004407 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |