| Doctor Name: | JILL HERGES |
| NPI Number: | 1376971515 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | R161450-5 |
| Business Practice Address: | 301 Highway 65 S Mora, MN - 550511899 |
| Business Phone Number: | 3206791212 |
| Business Fax Number: | |
| Mailing Address: | 1877 145th Ave, OGILVIE |
| State: | MN |
| Postal Code: | 563583649 |
| Phone Number: | 3206794605 |
| Fax Number: | |
| NPI Enumeration Date: | 10/25/2013 |
| NPI Last Update Date: | 10/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R161450-5 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |