MEDICARE: MRS. BRENDA HILL PNP-BC

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	363LP0200X	Pediatric Nurse Practitioner	APN0000006370	TN

General Provider Information

NPI Number	:	1851667992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRENDA HILL PNP-BC

Provider Business Mailing Address
First Line	:	920 MADISON AVE, SUITE 513
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-2120
Country	:	US
Telephone Number	:	901-448-4146
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 MADISON AVE, SUITE 513
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-2120
Country	:	US
Telephone Number	:	901-448-4146
Fax Number	:

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

Provider Enumeration Date	:	03/22/2012
Last Update Date	:	03/22/2012

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