Healthcare Provider Details

I. General information

NPI: 1821069212
Provider Name (Legal Business Name): CONSTANCE JEAN HILL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E H ST
MC COOK NE
69001-3482
US

IV. Provider business mailing address

42465 HIGHWAY 6/34
ARAPAHOE NE
68922-5575
US

V. Phone/Fax

Practice location:
  • Phone: 308-344-2650
  • Fax: 308-344-8358
Mailing address:
  • Phone: 308-697-4984
  • Fax: 308-697-4984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number100806
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: