Healthcare Provider Details

I. General information

NPI: 1184930869
Provider Name (Legal Business Name): KATRINA J HILLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2010
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 HICKORY LOOP
LAS CRUCES NM
88005-6587
US

IV. Provider business mailing address

301 PERKINS DR STE B
LAS CRUCES NM
88005-3248
US

V. Phone/Fax

Practice location:
  • Phone: 575-652-3155
  • Fax: 575-652-4104
Mailing address:
  • Phone: 575-652-3155
  • Fax: 575-652-4104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-09-5850
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: