Healthcare Provider Details
I. General information
NPI: 1104165000
Provider Name (Legal Business Name): MRS. KRISTIN ANNE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/12/2013
Last Update Date: 02/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5204 E 254TH ST UNITED STATES
CLEVELAND MO
64734-8133
US
IV. Provider business mailing address
5204 E 254TH ST UNITED STATES
CLEVELAND MO
64734-8133
US
V. Phone/Fax
- Phone: 816-250-2951
- Fax: 816-213-6174
- Phone: 816-250-2951
- Fax: 816-213-6174
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: