1033258926 NPI number — MS. MELANIE JO HILL MSN, APRN, FNP-BC

Table of content: MS. MELANIE JO HILL MSN, APRN, FNP-BC (NPI 1033258926)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033258926 NPI number — MS. MELANIE JO HILL MSN, APRN, FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILL
Provider First Name:
MELANIE
Provider Middle Name:
JO
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSN, APRN, FNP-BC
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:
1033258926
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1781 BANBURY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HERNANDO
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38632-8071
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-568-7655
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1021 CASINO CENTER DR
Provider Second Line Business Practice Location Address:
CAESAR'S HEALTH AND WELLNESS CENTER
Provider Business Practice Location Address City Name:
ROBINSONVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38664-9708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-357-3264
Provider Business Practice Location Address Fax Number:
662-357-6092
Provider Enumeration Date:
02/06/2007

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: 363LF0000X , with the licence number:  R875859 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: APN0000011258 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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