Healthcare Provider Details

I. General information

NPI: 1235716697
Provider Name (Legal Business Name): NICOLE HILL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 KINGSLEY AVE STE F
ORANGE PARK FL
32073-4528
US

IV. Provider business mailing address

1406 KINGSLEY AVE STE F
ORANGE PARK FL
32073-4528
US

V. Phone/Fax

Practice location:
  • Phone: 904-849-2566
  • Fax: 904-877-3641
Mailing address:
  • Phone: 904-386-0683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number9402992
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11013487
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: