MEDICARE: JAIME RENAE HILL MA, CCC-SLP

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	235Z00000X	Speech-Language Pathologist	1413	NE

General Provider Information

NPI Number	:	1295040442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME RENAE HILL MA, CCC-SLP

Provider Business Mailing Address
First Line	:	8200 DODGE ST
Second Line	:	CHILDREN'S HOSPITAL & MEDICAL CENTER
City	:	OMAHA
State	:	NE
Zip	:	68114-4113
Country	:	US
Telephone Number	:	402-955-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 N 175TH ST STE 1100
Second Line	:	CHILDREN'S HOSPITAL & MEDICAL CENTER - WVP
City	:	OMAHA
State	:	NE
Zip	:	68118-3582
Country	:	US
Telephone Number	:	402-955-8350
Fax Number	:	402-955-7396

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

Provider Enumeration Date	:	08/12/2010
Last Update Date	:	08/12/2010

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