Provider Demographics
NPI:1003113044
Name:HILL, KELLY LYNETTE
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LYNETTE
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7968 MILL CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5805
Mailing Address - Country:US
Mailing Address - Phone:513-371-0331
Mailing Address - Fax:
Practice Address - Street 1:7341 KINGSWOOD DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2646
Practice Address - Country:US
Practice Address - Phone:513-256-8950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN. 318677163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health