MEDICARE: DEBORAH HILL P.N.P.

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	363L00000X	Nurse Practitioner	218644-4405	UT

General Provider Information

NPI Number	:	1821016015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH HILL P.N.P.

Provider Business Mailing Address
First Line	:	3412 S 25TH E
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4967
Country	:	US
Telephone Number	:	208-497-0680
Fax Number	:	208-497-0650

Provider Business Practice Location Address
First Line	:	3412 S 25TH E
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4967
Country	:	US
Telephone Number	:	208-497-0680
Fax Number	:	208-497-0650

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	01/19/2021

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