Healthcare Provider Details

I. General information

NPI: 1689305344
Provider Name (Legal Business Name): SYSILIE JUSTINE HILL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 E MAIN ST
COLUMBUS OH
43205-1902
US

IV. Provider business mailing address

2780 AIRPORT DR STE 100
COLUMBUS OH
43219-2289
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-5535
  • Fax: 614-645-5546
Mailing address:
  • Phone: 614-859-1906
  • Fax: 614-645-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN.471932
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: