Healthcare Provider Details

I. General information

NPI: 1174906937
Provider Name (Legal Business Name): BRIDGETTE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 S COOPER ST SUITE 103-972
ARLINGTON TX
76015-3446
US

IV. Provider business mailing address

3415 S COOPER ST SUITE 103-972
ARLINGTON TX
76015-3446
US

V. Phone/Fax

Practice location:
  • Phone: 469-231-4935
  • Fax:
Mailing address:
  • Phone: 469-231-4935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number10-3504
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: