MEDICARE: MR. TOBIN EARL HILL ARNP

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	363L00000X	Nurse Practitioner	54730	ID
2	363L00000X	Nurse Practitioner	AP30006192	WA
3	363L00000X	Nurse Practitioner	12712346-4405	UT

General Provider Information

NPI Number	:	1386607026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TOBIN EARL HILL ARNP

Provider Business Mailing Address
First Line	:	2132 N 1700 W
Second Line	:	STE 110
City	:	LAYTON
State	:	UT
Zip	:	84041-7059
Country	:	US
Telephone Number	:	801-779-3500
Fax Number	:	801-779-3508

Provider Business Practice Location Address
First Line	:	2132 N 1700 W
Second Line	:	STE 110
City	:	LAYTON
State	:	UT
Zip	:	84041-7059
Country	:	US
Telephone Number	:	801-779-3500
Fax Number	:	801-779-3508

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	05/06/2022

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