MEDICARE: ANTOINESE HILL PMHNP

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	163WE0003X	Emergency Registered Nurse	450799	OH
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	450799	OH
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0036137	OH
4	163W00000X	Registered Nurse	450799	OH

General Provider Information

NPI Number	:	1992492656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTOINESE HILL PMHNP

Provider Business Mailing Address
First Line	:	6974 SUMMERGREEN DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-3978
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6974 SUMMERGREEN DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45424-3978
Country	:	US
Telephone Number	:	937-684-5240
Fax Number	:

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

Provider Enumeration Date	:	04/21/2023
Last Update Date	:	06/09/2024

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Directions to “ ANTOINESE HILL PMHNP” Practice Location

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