Healthcare Provider Details

I. General information

NPI: 1487403820
Provider Name (Legal Business Name): LASHE HILL EMT-B
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 LAW LN
BLOOMINGTON IN
47408-2109
US

IV. Provider business mailing address

5088 AUDREY AVE APT 209
INDIANAPOLIS IN
46254-5719
US

V. Phone/Fax

Practice location:
  • Phone: 812-855-7772
  • Fax:
Mailing address:
  • Phone: 260-564-3926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: