Healthcare Provider Details

I. General information

NPI: 1396525705
Provider Name (Legal Business Name): JOSEPH ROSS HILL FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MASSACHUSETTS ST
LAWRENCE KS
66046-4827
US

IV. Provider business mailing address

2415 MASSACHUSETTS ST
LAWRENCE KS
66046-4827
US

V. Phone/Fax

Practice location:
  • Phone: 785-832-4889
  • Fax: 785-832-4887
Mailing address:
  • Phone: 785-832-4889
  • Fax: 785-832-4887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-82618-121
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9379303
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: