Healthcare Provider Details

I. General information

NPI: 1861316549
Provider Name (Legal Business Name): MS. RONNIE MARSHUN HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6309 MACK AVE
DETROIT MI
48207-2302
US

IV. Provider business mailing address

290 TOWN CENTER DR STE 410
DEARBORN MI
48126-2765
US

V. Phone/Fax

Practice location:
  • Phone: 313-921-4700
  • Fax:
Mailing address:
  • Phone: 313-396-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number4704271142
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: