Healthcare Provider Details

I. General information

NPI: 1861934390
Provider Name (Legal Business Name): JENNIFER HILL PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E BANDERA RD STE 406
BOERNE TX
78006-2853
US

IV. Provider business mailing address

124 E BANDERA RD STE 406
BOERNE TX
78006-2853
US

V. Phone/Fax

Practice location:
  • Phone: 210-290-8350
  • Fax:
Mailing address:
  • Phone: 210-290-8350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP132604
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: