MEDICARE: CAROL L HILL APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	47040865964	MI

General Provider Information

NPI Number	:	1124108667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL L HILL APN

Provider Business Mailing Address
First Line	:	1150 BENNINGTON DR
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-3921
Country	:	US
Telephone Number	:	517-323-0533
Fax Number	:

Provider Business Practice Location Address
First Line	:	2025 S WASHINGTON AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-0828
Country	:	US
Telephone Number	:	517-267-3925
Fax Number	:	517-267-3593

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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