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NPI Code Detail

MEDICARE: NICOLE HILL

MEDICARE: NICOLE 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1770004053
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE HILL
Provider Business Mailing Address
First Line : 1683 OLYMPIA CT NW
Second Line :
City : SALEM
State : OR
Zip : 97304-2094
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 525 W UMPQUA ST
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-2952
Country : US
Telephone Number : 541-464-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2017
Last Update Date : 06/27/2017

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Directions to “ NICOLE HILL ” Practice Location

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