Healthcare Provider Details

I. General information

NPI: 1013756451
Provider Name (Legal Business Name): CHARLES DONALD HILL JR. MSN, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 05/24/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 NC HIGHWAY 94 N
CRESWELL NC
27928-8300
US

IV. Provider business mailing address

9500 NC HIGHWAY 94 N
CRESWELL NC
27928-8300
US

V. Phone/Fax

Practice location:
  • Phone: 252-797-0135
  • Fax:
Mailing address:
  • Phone: 252-797-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5020115
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: