Healthcare Provider Details
I. General information
NPI: 1902481195
Provider Name (Legal Business Name): ASHLEY HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/10/2021
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1235 MOUNT OLIVE RIDGE RD
BELLEVILLE WV
26133-8598
US
IV. Provider business mailing address
PO BOX 153
MINERAL WELLS WV
26150-0153
US
V. Phone/Fax
- Phone: 304-514-1951
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: