=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093594046
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAIME D HILL APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2023
-----------------------------------------------------
Last Update Date | 03/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 49 JOHNSON RD
-----------------------------------------------------
City | THE PLAINS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45780-1146
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-597-3186
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2624 LITTLE KYGER RD
-----------------------------------------------------
City | CHESHIRE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45620-9569
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-597-3186
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0035063
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------