MEDICARE: MS. KIMBERLY MONICA HILL RN

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	75221	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	75221	OTHER	NE	REGISTERED NURSE

General Provider Information

NPI Number	:	1730776246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY MONICA HILL RN

Provider Business Mailing Address
First Line	:	7362 POTTER ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68122-1504
Country	:	US
Telephone Number	:	402-813-7816
Fax Number	:

Provider Business Practice Location Address
First Line	:	7362 POTTER ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68122-1504
Country	:	US
Telephone Number	:	402-813-7816
Fax Number	:

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

Provider Enumeration Date	:	12/30/2020
Last Update Date	:	12/30/2020

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