MEDICARE: KELLEY L HILL NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN0000007030	TN
2	363LF0000X	Family Nurse Practitioner	7030	TN

General Provider Information

NPI Number	:	1023148343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLEY L HILL NP

Provider Business Mailing Address
First Line	:	PO BOX 11589
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37401-2589
Country	:	US
Telephone Number	:	423-778-3274
Fax Number	:	423-778-2255

Provider Business Practice Location Address
First Line	:	979 EAST THIRD STREET
Second Line	:	SUITE C-520
City	:	CHATTANOOGA
State	:	TN
Zip	:	37403-2137
Country	:	US
Telephone Number	:	423-778-5661
Fax Number	:	423-778-5664

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	05/05/2011

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