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General NPI Number Information
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NPI Number | 1679814073
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Entity Type | Individual
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Provider Name | BRIAN HILL
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Gender | Male
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Dates
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Enumeration Date | 03/09/2013
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 326 REXFORD DR
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City | MOORE
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State | SC
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Zip | 29369-9478
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Country | US
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Telephone | 989-450-9585
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Fax |
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Provider Business Mailing Address
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Address Line | 138 TOURNAMENT PT
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City | DUNCAN
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State | SC
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Zip | 29334-9265
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 103498
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 18280
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License Number State | SC
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