Healthcare Provider Details
I. General information
NPI: 1982093464
Provider Name (Legal Business Name): SUSAN PAIGE HILL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/21/2015
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
860 MONTCLAIR RD SUITE 955
BIRMINGHAM AL
35213-1923
US
IV. Provider business mailing address
860 MONTCLAIR RD SUITE 955
BIRMINGHAM AL
35213-1923
US
V. Phone/Fax
- Phone: 205-332-3160
- Fax: 866-702-0880
- Phone: 205-332-3160
- Fax: 866-702-0880
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | 1-137731 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: