Healthcare Provider Details

I. General information

NPI: 1750105136
Provider Name (Legal Business Name): HUAN HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8205 SPAIN RD NE
ALBUQUERQUE NM
87109-3179
US

IV. Provider business mailing address

948 CAMINO DE LA TIERRA
CORRALES NM
87048-6909
US

V. Phone/Fax

Practice location:
  • Phone: 505-856-0300
  • Fax:
Mailing address:
  • Phone: 505-803-5664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: