Healthcare Provider Details

I. General information

NPI: 1376144121
Provider Name (Legal Business Name): HEATHER HARDY HILL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2402 WAYNE MEMORIAL DR
GOLDSBORO NC
27534-1728
US

IV. Provider business mailing address

2402 WAYNE MEMORIAL DR
GOLDSBORO NC
27534-1728
US

V. Phone/Fax

Practice location:
  • Phone: 919-735-1387
  • Fax:
Mailing address:
  • Phone: 919-750-5508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5013759
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: