Healthcare Provider Details

I. General information

NPI: 1275437733
Provider Name (Legal Business Name): PAMELA HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15256 CROSSROADS PKWY # 2204
GULFPORT MS
39503-3564
US

IV. Provider business mailing address

965 28TH ST
GULFPORT MS
39501-5323
US

V. Phone/Fax

Practice location:
  • Phone: 228-539-3393
  • Fax:
Mailing address:
  • Phone: 228-313-3739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number3979
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: