Provider Demographics
NPI:1003917824
Name:HILL, LAURIE B (CNM)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:B
Last Name:HILL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:864-489-3286
Mailing Address - Fax:864-489-6694
Practice Address - Street 1:1506 N LIMESTONE ST
Practice Address - Street 2:SUITE B
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4747
Practice Address - Country:US
Practice Address - Phone:864-487-4573
Practice Address - Fax:864-488-0966
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2845367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC202660098OtherGAFFNEY MEDICAL ASSOCIATES
SC202660098OtherGAFFNEY HMA PHYSICIAN MANAGEMENT
SCGP4210Medicaid
SCGP4210Medicaid
SCQ34733Medicare UPIN
SC202660098OtherGAFFNEY MEDICAL ASSOCIATES