MEDICARE: MARISSA NICOLE 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	163W00000X	Registered Nurse	RN61272542	WA

General Provider Information

NPI Number	:	1700684115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA NICOLE HILL

Provider Business Mailing Address
First Line	:	15214 FERN ST SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-1008
Country	:	US
Telephone Number	:	251-753-3192
Fax Number	:

Provider Business Practice Location Address
First Line	:	15214 FERN ST SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-1008
Country	:	US
Telephone Number	:	251-753-3192
Fax Number	:

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

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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