MEDICARE: RACHAEL HILL MS

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	2255A2300X	Athletic Trainer	36002599A	IN

General Provider Information

NPI Number	:	1518332246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL HILL MS

Provider Business Mailing Address
First Line	:	7925 GRAYFIELD CT
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-3160
Country	:	US
Telephone Number	:	979-422-4768
Fax Number	:

Provider Business Practice Location Address
First Line	:	7925 GRAYFIELD CT
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-3160
Country	:	US
Telephone Number	:	979-422-4768
Fax Number	:

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

Provider Enumeration Date	:	12/07/2015
Last Update Date	:	03/29/2021

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