1356482590 NPI number — DR. DONNA J ST HILLIER PHD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356482590 NPI number — DR. DONNA J ST HILLIER PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ST HILLIER
Provider First Name:
DONNA
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356482590
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 37084
Provider Second Line Business Mailing Address:
219 E 5TH AVE
Provider Business Mailing Address City Name:
TALLAHASSEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-847-1107
Provider Business Mailing Address Fax Number:
850-224-3404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
219 E 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TALLAHASSEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-847-1107
Provider Business Practice Location Address Fax Number:
850-224-3404
Provider Enumeration Date:
02/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  0495 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 486 . This is a "CHP VENDOR #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 70922 . This is a "UBH" identifier . This identifiers is of the category "OTHER".
  • Identifier: Z1521 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 104515 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".




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