MEDICARE: GLENDA HILL

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	374U00000X	Home Health Aide		ND

General Provider Information

NPI Number	:	1619658036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENDA HILL

Provider Business Mailing Address
First Line	:	1820 40TH ST S APT 121
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58103-4467
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 40TH ST S APT 121
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58103-4467
Country	:	US
Telephone Number	:	701-200-5925
Fax Number	:

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

Provider Enumeration Date	:	07/27/2023
Last Update Date	:	07/27/2023

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Directions to “ GLENDA HILL ” Practice Location

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