Healthcare Provider Details

I. General information

NPI: 1336755669
Provider Name (Legal Business Name): HANNAH LEIGH HILL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 09/22/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 BUCKSKIN DR
WARNER ROBINS GA
31088-7707
US

IV. Provider business mailing address

205 BUCKSKIN DR
WARNER ROBINS GA
31088-7707
US

V. Phone/Fax

Practice location:
  • Phone: 478-235-4229
  • Fax:
Mailing address:
  • Phone: 478-235-4229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN256160
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN256160
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: