Provider Demographics
NPI:1003441544
Name:HILL, MICHELLE RENEE (FNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55942 DAY RD
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:MI
Mailing Address - Zip Code:49067-9342
Mailing Address - Country:US
Mailing Address - Phone:269-718-7645
Mailing Address - Fax:
Practice Address - Street 1:1241 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MI
Practice Address - Zip Code:49093-8319
Practice Address - Country:US
Practice Address - Phone:269-273-9539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704268553363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care