Healthcare Provider Details

I. General information

NPI: 1487224028
Provider Name (Legal Business Name): RICHARD BRANDON HILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 KEYSER AVE
NATCHITOCHES LA
71457-6037
US

IV. Provider business mailing address

10481 PLUM CREEK DR
SHREVEPORT LA
71106-8530
US

V. Phone/Fax

Practice location:
  • Phone: 318-238-5300
  • Fax:
Mailing address:
  • Phone: 318-294-0731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number221500
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: