Healthcare Provider Details

I. General information

NPI: 1992419410
Provider Name (Legal Business Name): NATEISHA SHAREE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 01/10/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 E WOOD ST
SPARTANBURG SC
29303-3016
US

IV. Provider business mailing address

7000 MAIDSTONE DR APT 6
BOILING SPRINGS SC
29316-6325
US

V. Phone/Fax

Practice location:
  • Phone: 864-596-2227
  • Fax:
Mailing address:
  • Phone: 864-590-6635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number218455
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: