MEDICARE: MRS. CRYSTAL HILL FNP-C

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	363LP2300X	Primary Care Nurse Practitioner	AP08565	LA
2	363LF0000X	Family Nurse Practitioner	AP08565	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	2409832	OTHER	LA	MEDICARE

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	:	1790140549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CRYSTAL HILL FNP-C

Provider Business Mailing Address
First Line	:	109 BAYOU BEND DR
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70364-1168
Country	:	US
Telephone Number	:	985-217-9171
Fax Number	:	985-251-2283

Provider Business Practice Location Address
First Line	:	740 JUSTA ST
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70380-1513
Country	:	US
Telephone Number	:	985-384-1726
Fax Number	:

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

Provider Enumeration Date	:	12/21/2015
Last Update Date	:	11/13/2024

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