Healthcare Provider Details

I. General information

NPI: 1316528136
Provider Name (Legal Business Name): DIANE N HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 GREENHAVEN DR
GREENVILLE OH
45331-8384
US

IV. Provider business mailing address

104 GREENHAVEN DR
GREENVILLE OH
45331-8384
US

V. Phone/Fax

Practice location:
  • Phone: 937-287-3120
  • Fax:
Mailing address:
  • Phone: 937-287-3120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: