Healthcare Provider Details

I. General information

NPI: 1922249994
Provider Name (Legal Business Name): DEIDRE M HILL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 03/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 RICE MINE RD N
TUSCALOOSA AL
35406-2314
US

IV. Provider business mailing address

2868 ACTON RD
BIRMINGHAM AL
35243-2502
US

V. Phone/Fax

Practice location:
  • Phone: 205-391-3099
  • Fax:
Mailing address:
  • Phone: 205-968-8360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-113585
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: