1093711442 NPI number — LINDA G HILL FNP, BC

Table of content: LINDA G HILL FNP, BC (NPI 1093711442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093711442 NPI number — LINDA G HILL FNP, BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILL
Provider First Name:
LINDA
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1093711442
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2371
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN ROSE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76043-2371
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-898-8499
Provider Business Mailing Address Fax Number:
254-898-8506

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1009 NE BIG BEND TRAIL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLEN ROSE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-898-8499
Provider Business Practice Location Address Fax Number:
254-898-8506
Provider Enumeration Date:
06/21/2005

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:  251622 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0064HW . This is a "BCBS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 039614502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 421533061 . This is a "TAX ID #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 152145201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8Y3991 . This is a "BCBS OF TEXAS - HOOD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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