Healthcare Provider Details

I. General information

NPI: 1386101103
Provider Name (Legal Business Name): ANDIE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 WOOD ST
CLARION PA
16214-1240
US

IV. Provider business mailing address

4246 E BUCKTOOTH RUN RD
LITTLE VALLEY NY
14755-9753
US

V. Phone/Fax

Practice location:
  • Phone: 716-801-1939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: