1134403199 NPI number — MISS BRIDGET ANNETTE HILL LPN

Table of content: MISS BRIDGET ANNETTE HILL LPN (NPI 1134403199)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134403199 NPI number — MISS BRIDGET ANNETTE HILL LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILL
Provider First Name:
BRIDGET
Provider Middle Name:
ANNETTE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LPN
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:
1134403199
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
406 N SPRING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCMINNVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37110-2134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
731-507-1212
Provider Business Mailing Address Fax Number:
731-507-1217

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
370 HAYGOOD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARTIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38237-5296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-587-2011
Provider Business Practice Location Address Fax Number:
731-587-2034
Provider Enumeration Date:
10/07/2011

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: 164W00000X , with the licence number:  LPN0000075791 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: LPN0000075791 . This is a "LICENSE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com