Basic Information
| Provider Information | |||||||||
| NPI: | 1891174546 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TESTERMAN | ||||||||
| FirstName: | JILL | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1006 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BOZEMAN | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597153219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4064144800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 602 E NOB HILL BLVD | ||||||||
| Address2: | |||||||||
| City: | YAKIMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 989013534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092483334 | ||||||||
| FaxNumber: | 5094536144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2015 | ||||||||
| LastUpdateDate: | 10/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN60578716 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 201407295NP-PP | OR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 132704 | MT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | AP60578720 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.