Healthcare Provider Details

I. General information

NPI: 1689628489
Provider Name (Legal Business Name): KATHY JO HILL MSN, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 MADISON AVENUE BOONE MEMORIAL HOSPITAL
MADISON WV
25130
US

IV. Provider business mailing address

143 1ST AVE W
MADISON WV
25130-1109
US

V. Phone/Fax

Practice location:
  • Phone: 304-369-1230
  • Fax: 304-369-4251
Mailing address:
  • Phone: 304-369-1855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberMH0736340
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: