MEDICARE: DR. KERRIE JO HILL PH.D.

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	103T00000X	Psychologist	00689	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	44942	OTHER	IA	WELLMARK BLUE CROSS
3	42105384450265-A019	OTHER	IA	TRIWEST
4	238702	OTHER	IA	MIDLANDS CHOICE

General Provider Information

NPI Number	:	1609894070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERRIE JO HILL PH.D.

Provider Business Mailing Address
First Line	:	939 OFFICE PARK RD STE 200
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2538
Country	:	US
Telephone Number	:	515-226-2512
Fax Number	:	515-440-3388

Provider Business Practice Location Address
First Line	:	939 OFFICE PARK RD STE 200
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2538
Country	:	US
Telephone Number	:	515-226-2512
Fax Number	:	515-440-3388

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

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

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Directions to “ DR. KERRIE JO HILL PH.D.” Practice Location

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