Healthcare Provider Details

I. General information

NPI: 1841060498
Provider Name (Legal Business Name): KEIRA HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MORRIS ST STE 201
CHARLESTON WV
25301-1853
US

IV. Provider business mailing address

400 ASSOCIATION DR STE 102
CHARLESTON WV
25311-1298
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-7700
  • Fax: 304-388-7755
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1003
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: