Healthcare Provider Details

I. General information

NPI: 1912703133
Provider Name (Legal Business Name): ZACHARY M HILLER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 2ND ST SW
ROCHESTER MN
55902-1970
US

IV. Provider business mailing address

1546 4TH AVE SW
ROCHESTER MN
55902-3809
US

V. Phone/Fax

Practice location:
  • Phone: 507-255-4769
  • Fax:
Mailing address:
  • Phone: 507-837-9956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number2481478
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: