Healthcare Provider Details

I. General information

NPI: 1447654942
Provider Name (Legal Business Name): JAMES STANLEY HILL JR. CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 MARTIN LUTHER KING JR BLVD STE 102
BALTIMORE MD
21201-1221
US

IV. Provider business mailing address

14502 GREENVIEW DR # 1003
LAUREL MD
20708-3287
US

V. Phone/Fax

Practice location:
  • Phone: 410-777-8971
  • Fax: 877-595-7180
Mailing address:
  • Phone: 757-218-2398
  • Fax: 240-770-0436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024171748
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC001392
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: