MEDICARE: MS. WANDA NEWBY HILL DNP FNP, FPMHNP-BC

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	R850602	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316928708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. WANDA NEWBY HILL DNP FNP, FPMHNP-BC

Provider Business Mailing Address
First Line	:	72A COUNTY ROAD 421
Second Line	:
City	:	TISHOMINGO
State	:	MS
Zip	:	38873-8728
Country	:	US
Telephone Number	:	662-438-7226
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 ALCORN DRIVE
Second Line	:	CROSSROADS CENTER
City	:	CORINTH
State	:	MS
Zip	:	38834-9321
Country	:	US
Telephone Number	:	662-293-4280
Fax Number	:	662-293-4282

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

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	04/13/2012

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