Healthcare Provider Details

I. General information

NPI: 1740024579
Provider Name (Legal Business Name): CARLA HILL APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 WATCHTOWER DR
ORMOND BEACH FL
32176-2886
US

IV. Provider business mailing address

1913 N CLYDE MORRIS BLVD
DAYTONA BEACH FL
32117-5519
US

V. Phone/Fax

Practice location:
  • Phone: 817-455-7427
  • Fax:
Mailing address:
  • Phone: 386-888-7890
  • Fax: 386-492-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11033607
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: