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General NPI Number Information
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NPI Number | 1700421211
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Entity Type | Individual
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Provider Name | MELISSA ANN HILL FNP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 212 W LAKE ST
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City | WACONIA
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State | MN
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Zip | 55387-1014
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Country | US
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Telephone | 651-603-4565
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Fax | 833-630-0621
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Provider Business Mailing Address
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Address Line | 901 EAGLE RIDGE TRL
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City | STILLWATER
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State | MN
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Zip | 55082-9121
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Country | US
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Telephone | 651-486-8371
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2016027219
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5198
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License Number State | MN
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