MEDICARE: AMADA HILL

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	RN165699	GA

General Provider Information

NPI Number	:	1558723734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMADA HILL

Provider Business Mailing Address
First Line	:	3507 MACKENZIE DR
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-1802
Country	:	US
Telephone Number	:	404-432-4014
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 PERMIAN WAY
Second Line	:	SUITE A
City	:	VILLA RICA
State	:	GA
Zip	:	30180-3252
Country	:	US
Telephone Number	:	770-771-5235
Fax Number	:	770-771-5236

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

Provider Enumeration Date	:	03/25/2016
Last Update Date	:	03/25/2016

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Directions to “ AMADA HILL ” Practice Location

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