1720201650 NPI number — SANDRA L HILL RN, MSW,LCSW, LSW

Table of content: SANDRA L HILL RN, MSW,LCSW, LSW (NPI 1720201650)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720201650 NPI number — SANDRA L HILL RN, MSW,LCSW, LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILL
Provider First Name:
SANDRA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MSW,LCSW, LSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HILL
Provider Other First Name:
SANDRA
Provider Other Middle Name:
L CLAIRE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, MSW, LCSW, LSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1720201650
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 242331
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANCHORAGE
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99524-2331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-250-4416
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 E DIMOND BLVD
Provider Second Line Business Practice Location Address:
SUITE 625
Provider Business Practice Location Address City Name:
ANCHORAGE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99515-2039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-250-4416
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2007

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: 1041C0700X , with the licence number:  AK0197 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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