Healthcare Provider Details

I. General information

NPI: 1447607965
Provider Name (Legal Business Name): MARY MARGARET HILL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY MULLANE APRN

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11365 DORSETT RD
MARYLAND HEIGHTS MO
63043-3411
US

IV. Provider business mailing address

11365 DORSETT RD
MARYLAND HEIGHTS MO
63043-3411
US

V. Phone/Fax

Practice location:
  • Phone: 314-872-6400
  • Fax: 314-872-6500
Mailing address:
  • Phone: 314-872-6400
  • Fax: 314-872-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2016002940
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: