MEDICARE: QUMARA HILL-SMITH

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	363LF0000X	Family Nurse Practitioner	11994	CT
2	363LF0000X	Family Nurse Practitioner	APRN11000901	FL
3	363LF0000X	Family Nurse Practitioner	AP61552287	WA
4	363LF0000X	Family Nurse Practitioner	RN183072	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871906024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUMARA HILL-SMITH

Provider Business Mailing Address
First Line	:	3350 RIVERWOOD PKWY SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-6401
Country	:	US
Telephone Number	:	404-996-0194
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 RIVERWOOD PKWY SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-6401
Country	:	US
Telephone Number	:	404-996-0194
Fax Number	:

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

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	11/13/2024

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Directions to “ QUMARA HILL-SMITH ” Practice Location

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