Healthcare Provider Details

I. General information

NPI: 1902993611
Provider Name (Legal Business Name): JANICE REBECCA HILL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 THOMPSON ST
HOMER GA
30547-3110
US

IV. Provider business mailing address

163 LEWIS CIR
COMMERCE GA
30529-1355
US

V. Phone/Fax

Practice location:
  • Phone: 706-677-2296
  • Fax: 706-677-4042
Mailing address:
  • Phone: 706-335-0911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN123287
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: