Healthcare Provider Details

I. General information

NPI: 1497647903
Provider Name (Legal Business Name): MACKENZI KAITLYN HILL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 PINE ST
MONTGOMERY AL
36106-1117
US

IV. Provider business mailing address

601 COUNTY ROAD 57
NOTASULGA AL
36866-2713
US

V. Phone/Fax

Practice location:
  • Phone: 334-293-8000
  • Fax:
Mailing address:
  • Phone: 334-451-1328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number1-198656
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: